Al-Obeidan Saleh A, Mousa Ahmed, Naseem Abid, Abu-Amero Khaled K, Osman Essam A
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Saudi Med J. 2013 Jan;34(1):54-61.
To investigate the efficacy and safety of deep sclerectomy (DS) in Saudi patients with primary and secondary open-angle glaucoma (OAG).
In this retrospective cohort study, a total of 194 eyes of 152 patients with OAG were consecutively enrolled to undergo DS with Mitomycin-C (MMC) at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia between January 2002 and September 2010. Age at surgery, gender, type of glaucoma, operated eye, previous ocular surgery, type of implant, pre and final visit visual acuities, intraocular pressure (IOP), number of anti-glaucoma medications, optic nerve cup/disc ratio, and complications were recorded.
Cases were followed up to a mean of 60.9 (+/-49.7) months. The IOP reduced from a preoperative mean of 25.6 (+/-10.3) to final visit of 13.5 (+/-4), whereas the mean number of anti-glaucoma medication also reduced from 2.95 (+/-0.93) to 0.22 (+/-0.63), which was statistically significant (p<0.0001). Complete success was 82%, while overall success was 90.2%. Patients <50 years (p=0.003), high IOP (>/=21) at baseline (p=0.039), and being exposed to previous surgeries (p=0.047) were significant risk factors for failure, while combining cataract and converting to penetrating surgery have significantly improved the success rate (p=0.037).
Deep sclerectomy provides significant IOP reduction with low rate of visual threatening complications in Saudi patients with open angle glaucoma.
探讨深层巩膜切除术（DS）治疗沙特原发性和继发性开角型青光眼（OAG）患者的疗效和安全性。
在这项回顾性队列研究中，2002年1月至2010年9月期间，沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院连续纳入152例OAG患者的194只眼睛，接受含丝裂霉素C（MMC）的DS手术。记录手术年龄、性别、青光眼类型、手术眼、既往眼部手术、植入物类型、术前和末次随访视力、眼压（IOP）、抗青光眼药物数量、视神经杯盘比及并发症。
病例平均随访60.9（±49.7）个月。眼压从术前平均25.6（±10.3）降至末次随访时的13.5（±4），抗青光眼药物平均数量也从2.95（±0.93）降至0.22（±0.63），差异有统计学意义（p<0.0001）。完全成功率为82%，总成功率为90.2%。年龄<50岁（p=0.003）、基线眼压高（≥21）（p=0.039）及既往接受过手术（p=0.047）是失败的显著危险因素，而联合白内障手术及改行穿透性手术可显著提高成功率（p=0.037）。
深层巩膜切除术可显著降低沙特开角型青光眼患者的眼压，且视觉威胁性并发症发生率低。
