180도와 360도 선택적 레이저섬유주성형술의 안압 하강효과 비교
Comparison of 180° and 360° Selective Laser Trabeculoplasty
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초록
목적: 선택적 레이저섬유주성형술에서 180°와 360° 조사 방법 간 효과를 비교하고자 하였다. 대상과 방법: 고안압증 및 원발개방각녹내장 환자 중 180°와 360° 각 1회 선택적 레이저섬유주성형술을 시행 받은 환자를 대상으로술 후 1일, 1주, 3개월, 6개월에 안압과 1일째 전방 내 염증 정도를 비교하였다. 결과: 술 후 1일(p=0.01)와 술 후 1주째(p=0.02) 안압은 180°군에서 유의하게 낮게 나타났으나, 이후 술 후 6개월(p=0.95) 두 그룹간의 유의한 차이를 보이지 않았다. 술 후 1일째 전방 내 염증 정도는 180°군보다 360°군에서 높았다(p=0.001). 360°군(43.3%)에서높은 성공률을 보였으나(180°군 31.3%, p=0.23), 통계학적인 유의성은 없었다. 고찰: 180° 선택적 레이저섬유주성형술은 360˚에 시행한 것과 유사한 안압하강 효과를 나타내었으므로 합병증이 적은 것을 고려한다면180° 방식이 더 바람직할 것으로 생각한다.
Abstract
Purpose: To compare the effect and safety of two regimens of Selective Laser Trabeculoplasty (SLT), SLT on 180° of trabecular meshwork and SLT with 100 laser spots on 360° of trabecular meshwork in patients with primary open-angle glaucoma and ocular hypertension. Methods: In a retrospective clinical study, the authors compared the pressure-lowering effects of SLT in two groups of patients; group 1 (83 patients) received SLT on 180°, group 2 (30 patients) on 360° of trabecular meshwork. The clinical outcome indicators included intraocular pressure (IOP) at one day, one week, one month, two months, three months and six months after SLT, and the anterior chamber reaction at post-laser one day. Results: There was no statistically significant difference in the IOP reduction between these two regimens after six months. The anterior chamber reactions in the two groups were significantly different (group 1; 0.61 ± 0.64, group 2; 1.25 ± 0.83,p = 0.001). The success rate of group 2 (43.3%) was not different from that of group 1 (31.3%; p = 0.23). Conclusions: SLT on 180° of trabecular meshwork had a similar effect compared to that of SLT on 360° of trabecular meshwork in terms of IOP reduction. The authors of the present study suggest that 180° SLT is the safest procedure with regard to success rate and complications.
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