Précis: 

Laser goniopuncture (LGP) is an effective outpatient procedure which has been shown to maintain reduced intraocular pressure (IOP) 5 years following initial laser treatment in patients who have had viscocanalostomy (VC) (with or without phacoemulsification).

Purpose: 

The purpose of this study was to establish the long term (5 y) efficacy of neodymium-doped:yttrium aluminum-garnet LGP to lower IOP following VC or phacoviscocanalostomy (PVC) in patients with glaucoma.

Patients and Methods: 

This retrospective study analyzed patients who underwent LGP following VC±phacoemulsification between 2009 and 2012 at the Stanley Eye Unit in Abergele. Reason for further intervention included either increasing IOP outside target range or worsening visual fields. Statistical analyses were performed comparing pregoniopucture values to those taken up to 5 years later.

Results: 

Of the 620 VC and PVC procedures performed between 2009 and 2012, 218 eyes underwent LGP after a mean of 25 months [95% confidence interval (CI): 22.58 to 27.41] following surgery. Patients having a PVC had a longer mean time to goniopuncture compared with those who were phakic and had VC only (P<0.001). Immediately following goniopuncture IOP dropped, and a statistically significant reduction persisted at 5 year follow-up (P<0.001). Goniopuncture reduced IOP significantly from a pretreatment value of 21 to 15 mm Hg over 5 years (95% CI) (χ²F₍₄₎=119.1, P<0.001). In total, 154 eyes (71%) were commenced on IOP-lowering medication at a mean of 14 months (95% CI: 12 to 17). At 5 years, successful IOP control was achieved in 73% (49 of 67) of eyes. There was no difference found between type of surgery and successful pressure control at 5 years (χ²₍₁₎=2.00, P=0.16).

Conclusion: 

LGP is an effective procedure which maintains a statistically significant reduction in IOP in the long term.

中文翻译：

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Nd:YAG 房角穿刺术对粘管吻合术和超声粘管吻合术的长期结果

概要： 

激光房角穿刺术(LGP) 是一种有效的门诊手术，已被证明可以在接受粘膜管吻合术 (VC)（伴或不伴超声乳化术）的患者初次激光治疗后 5 年内维持降低的眼内压 (IOP)。

目的： 

本研究的目的是确定掺钕：钇铝石榴石导光板对青光眼患者 VC 或超声乳化管腔吻合术 (PVC) 后降低 IOP 的长期（5 年）疗效。

患者和方法： 

这项回顾性研究分析了 2009 年至 2012 年在阿伯格勒斯坦利眼科病房接受 VC ± 超声乳化吸除术后接受 LGP 的患者。进一步干预的原因包括眼压升高超出目标范围或视野恶化。进行统计分析，将术前检查值与 5 年后的值进行比较。

结果： 

在 2009 年至 2012 年间进行的 620 例 VC 和 PVC 手术中，218 只眼睛在术后平均 25 个月后接受了 LGP [95% 置信区间 (CI)：22.58 至 27.41]。与有晶状体眼且仅患有 VC 的患者相比，患有PVC 的患者进行房角穿刺的平均时间更长( P <0.001)。房角穿刺后眼压立即下降，并且在 5 年随访中持续显着降低（P <0.001）。五年内，房角穿刺使眼压从治疗前的 21 毫米汞柱显着降低至 15 毫米汞柱 (95% CI) (χ ² F ₍₄₎ =119.1，P <0.001）。总共有 154 只眼睛 (71%) 开始接受降眼压药物治疗，平均时间为 14 个月 (95% CI：12 至 17)。5 年时，73% 的眼睛（67 只眼睛中的 49 只）成功控制了眼压。5 年时，手术类型与成功的压力控制之间没有发现差异（χ ² ₍₁₎ =2.00，P =0.16）。

结论： 

LGP 是一种有效的手术，可以长期保持眼压的统计显着降低。