Department of Neuroscience, Ophthalmology, University of Pisa, Via Paradisa, 2 - Edificio 30, Pisa 56100, Italy.
Br J Ophthalmol. 2011 Nov;95(11):1537-41. doi: 10.1136/bjophthalmol-2011-300308. Epub 2011 Aug 26.
This study aimed to evaluate the efficacy of Gold Micro Shunt (GMS) for suprachoroidal drainage in patients with refractory glaucoma.
This is a prospective uncontrolled case series study. Fifty-five eyes of 55 patients were included. Study eyes underwent GMS implantation in the supraciliary space. Follow-up visits were performed on day 1, week 1 and months 1, 3, 6, 12 and 24; patients underwent slit-lamp examination, Goldmann applanation tonometry, ultrasound biomicroscopy and gonioscopy.
Before inclusion, the eyes underwent an average (± SD) of 1.9 ± 0.7 (range 1-5) previous glaucoma surgery procedures. Forty eyes were pseudophakic, 12 were phakic and 3 were aphakic. The mean baseline intraocular pressure was 30.8 ± 8.8 mm Hg (range 22-58 mm Hg) despite maximal medical treatment. After 2 years of follow-up, qualified success was achieved in 37 eyes (67.3%) and complete success was achieved in 3 eyes (5.5%). In success group patients, mean intraocular pressure decreased from 27.6 ± 6.9 at baseline to 13.7 ± 2.98 mm Hg after 2 years of follow-up; the mean (± SD) number of medications was 1.4 ± 0.7 in the postoperative phase, compared with a value of 2.5 ± 0.9 in the preoperative phase. Mild side effects occurred in 21 patients, with mild or moderate postoperative hyphema being the most frequent one. Development of a thin membrane, obstructing the anterior holes, was the most important factor affecting the efficacy of this device; it was found to be present in 12 patients from the failure group (66.7% of failures).
GMS achieved qualified success in about 67.3% of eyes with uncontrolled refractory glaucoma with a low rate of complications.
本研究旨在评估 Gold Micro Shunt（GMS）用于治疗难治性青光眼患者脉络膜上腔引流的疗效。
这是一项前瞻性非对照病例系列研究。纳入 55 例 55 只眼。研究眼行巩膜睫状体空间 GMS 植入术。术后第 1、1 周及术后 1、3、6、12、24 个月随访；患者接受裂隙灯检查、压平眼压计测量、超声生物显微镜和房角镜检查。
纳入前，患者平均（± SD）接受过 1.9 ± 0.7 次（范围 1-5 次）先前的青光眼手术。40 只眼为白内障术后，12 只眼为晶状体眼，3 只眼为无晶状体眼。尽管接受了最大程度的药物治疗，平均基线眼压仍为 30.8 ± 8.8mmHg（范围 22-58mmHg）。2 年随访后，37 只眼（67.3%）获得合格成功，3 只眼（5.5%）获得完全成功。在成功组患者中，平均眼压从基线时的 27.6 ± 6.9mmHg 下降至 2 年随访时的 13.7 ± 2.98mmHg；术后阶段平均（± SD）用药数为 1.4 ± 0.7，术前阶段为 2.5 ± 0.9。21 例患者出现轻度副作用，最常见的是术后轻度或中度前房积血。薄膜的形成，阻塞前孔，是影响该装置疗效的最重要因素；在失败组的 12 例患者（失败患者的 66.7%）中发现了这种情况。
GMS 治疗难治性青光眼控制不良的患者获得了约 67.3%的合格成功率，且并发症发生率较低。
