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Intraocular Pressure Reduction after Selective Laser Trabeculoplasty in Primary Open Angle Glaucoma

انخفاض الضغط داخل المقلة بعد تصنيع التربيق الانتقائي بالليزر في الزرق البدئي مفتوح الزاوية

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 Publication date 2013
and research's language is العربية
 Created by Shamra Editor




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The aim of this clinical study was to investigate the intraocular pressure (IOP) reduction after selective laser trabeculoplasty (SLT) in patients with primary open-angle glaucoma (POAG). The research has been done in Alassad Hospital, Tishreen university, Lattakia, from Feb 2009 to Feb 2011. Fifty eyes with uncontrolled POAG were treated with a frequency doubled, Q-switched Nd:YAG laser (532 nm).The pattern of treatment was applying approximately 50 burns to 180 degrees of the trabecular meshwork at energy levels ranging from 0.40– 0.92 mJ per pulse. After SLT eyes were maintained with the identical hypotensive medical therapy as that before treatment. IOP was measured before treatment, 1 and 7 days after treatment and 1, 3, 6 and 12 months after treatment. The mean pretreatment IOP was 22.48 (SD 1.84) mmHg. At the end of 1 month follow-up period the mean reduction of IOP was 4.86 mmHg (21.6%); after 3 months the mean reduction was 5.66 mmHg (25.2%); after 6 months the mean reduction of IOP was 5.06 mmHg (22.5%); at the end of 12 months follow-up period the mean reduction was 4.92 mmHg (21.9%). It can be concluded that SLT presents a new and effective method of IOP reduction in the treatment of POAG.


Artificial intelligence review:
Research summary
تهدف هذه الدراسة السريرية إلى التحقق من انخفاض الضغط داخل المقلة بعد تصنيع التربيق الانتقائي بالليزر في مرضى الزرق البدئي مفتوح الزاوية. أجريت الدراسة في مشفى الأسد الجامعي بجامعة تشرين في اللاذقية خلال الفترة من فبراير 2009 إلى فبراير 2011. تمت معالجة خمسين عيناً باستخدام ليزر ياغ مضاعف التواتر (532 نانومتر). تم تطبيق 50 حرقاً على امتداد 180 درجة من شبكة التربيق بطاقة تتراوح بين 0.40 و 0.92 ميلي جول لكل نبضة. تم قياس الضغط داخل المقلة قبل المعالجة وفي الأيام 1 و 7 بعد المعالجة، ثم بعد 1 و 3 و 6 و 12 شهر. كان الضغط الوسطي قبل المعالجة 22.48 مم ز. وكان معدل الانخفاض في نهاية الشهر الأول 4.86 مم ز (21.6%)، وبعد 3 أشهر 5.66 مم ز (25.2%)، وبعد 6 أشهر 5.06 مم ز (22.5%)، وبعد 12 شهر 4.92 مم ز (21.9%). يمكن الاستنتاج أن تصنيع التربيق الانتقائي بالليزر يمثل طريقة جديدة وفعالة لخفض الضغط داخل المقلة في مرضى الزرق البدئي مفتوح الزاوية.
Critical review
دراسة نقدية: تعتبر هذه الدراسة خطوة مهمة في مجال علاج الزرق البدئي مفتوح الزاوية باستخدام تقنية الليزر. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، كان من الأفضل تضمين مجموعة تحكم للمقارنة بين نتائج العلاج بالليزر والعلاج التقليدي. ثانياً، لم يتم التطرق إلى الآثار الجانبية المحتملة للعلاج بالليزر بشكل كافٍ. ثالثاً، كان من الممكن توسيع نطاق الدراسة لتشمل عدد أكبر من المرضى وفترة متابعة أطول للتأكد من استدامة النتائج. بشكل عام، تعتبر الدراسة قيمة ولكن هناك مجال للتحسين في التصميم والمنهجية.
Questions related to the research
  1. ما هو الهدف الرئيسي من هذه الدراسة؟

    الهدف الرئيسي هو التحقق من انخفاض الضغط داخل المقلة بعد تصنيع التربيق الانتقائي بالليزر في مرضى الزرق البدئي مفتوح الزاوية.

  2. ما هي التقنية المستخدمة في العلاج في هذه الدراسة؟

    تم استخدام ليزر ياغ مضاعف التواتر (532 نانومتر) لتطبيق 50 حرقاً على امتداد 180 درجة من شبكة التربيق.

  3. ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟

    أظهرت الدراسة أن تصنيع التربيق الانتقائي بالليزر أدى إلى انخفاض ملحوظ في الضغط داخل المقلة، حيث بلغ معدل الانخفاض بعد 12 شهر 4.92 مم ز (21.9%).

  4. ما هي النقاط التي يمكن تحسينها في هذه الدراسة؟

    يمكن تحسين الدراسة من خلال تضمين مجموعة تحكم، التطرق بشكل أعمق إلى الآثار الجانبية المحتملة، وتوسيع نطاق الدراسة لتشمل عدد أكبر من المرضى وفترة متابعة أطول.


References used
LATINA,M.A; PARK,C. Selective targeting of trabecular meshwork cells: In vitro studies of pulsed and CW laser interactions. Exp Eye Res U.S.A.Vol.60, N.4, 1995, 359–371
LATINA,M.A; SIBAYAN,S.A; SHIN,D.H; NOECKER,R.J; MARCELLINO,G.Qswitched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty). Ophthalmology U.S.A. vol.105, N. 11, 1998, 2082–2090
DAMJI, K.F; SHAH,K.C;ROCK,W.J;BAINS,H.S;HODGE,W.G.Selective laser trabeculoplastyvargon laser trabeculoplasty:a prospective randomised clinical trial. Br J OphthalmolU.K. Vol. 83, N. 6, 1999,718-722
KAULEN, P.; RICHTER, A; WIEMER, C. Selective laser trabeculoplasty- results during the first two years.KlinMonatsbl Augenheilkd GERMANY. Vol. 213,1998, S12
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