약물 치료중인 개방각녹내장 환자에서의 패턴 레이저섬유주성형술의 안압 하강효과
Pattern Laser Trabeculoplasty Intraocular Pressure Reduction Efficacy in Open-Angle Glaucoma Patients on Medical Therapy
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목적: 원발개방각녹내장 및 정상압녹내장 환자를 대상으로 파스칼 레이저를 이용한 패턴 레이저 섬유주성형술을 시행하고 그 효과에대해 알아보았다. 대상과 방법: 추가적인 안압 하강이 필요한 원발개방각녹내장 26안(23명) 및 정상압녹내장 14안(12명)의 환자군을 대상으로 파스칼 레이저를 이용한 패턴 레이저 섬유주성형술을 시행 후 1주, 1개월, 3개월, 6개월 및 9개월까지의 안압 변화를 분석하였다. 결과: 원발개방각녹내장군에서 안압은 치료 전 20.7 ± 4.1 (mean ± SD) mmHg에서 치료 1개월 후 16.4 ± 3.1 mmHg이었으며 6개월후 16.9 ± 3.8 mmHg, 9개월 후 16.5 ± 5.2 mmHg 측정되었으며, 치료 후 측정한 모든 시점에서 치료 전과 비교할 때 통계적으로유의하게 감소된 후 유지되고 있음을 확인할 수 있었다. 하지만 정상압녹내장군에서는 통계적으로 유의한 안압 하강 효과를 보여주지못하고 있으며, 1개월 이후부터는 오히려 평균 안압이 증가하는 경향을 보여주고 있다. 결론: 원발개방각녹내장환자의 경우 패턴 레이저 섬유주성형술은 추가적인 약물사용의 감소 가능성을 보여주고 있다. 또한 최대 내약용으로 약물 치료중인 경우에는 수술적 치료 전에 고려할 수 있는 보조적인 대안으로의 가능성을 생각해 볼 수 있겠다.
Abstract
Purpose: To assess the effectiveness and safety of Pattern Laser Trabeculoplasty (PLT) in patients with primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG). Methods: Twenty-six eyes in patients with POAG and 14 eyes in patients with NTG were targeted in this study. The intraocular pressure (IOP) for each patient needed to be reduced within proper ranges. The clinical outcome was assessed by IOP at 1 week, 1 month, 3 months, 6 months and 9 months after PLT. Results: The mean (± standard deviation) IOP in the POAG group was 20.7 ± 4.1 mm Hg before treatment. After PLT, the IOPs in POAG group were 16.4 ± 3.1 mm Hg, 16.9 ± 3.8 mm Hg, and 16.5 ± 5.2 mm Hg at 1, 6 and 9 months, respectively,and the pressure remained stabled over 9 months of post-procedural follow-up. However, no statistical difference in IOP reduction was observed in the NTG group before and after treatment. Conclusions: PLT provides a possibility to decrease additional medical therapy in patients with POAG. In addition, PLT can be considered as an auxiliary therapy for POAG patients who tolerate maximal medical therapy prior to undergoing surgical treatment.
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