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[青少年特发性关节炎相关葡萄膜炎中的小梁切除术:儿童继发性青光眼的长期结果]

[Trabeculectomy in uveitis associated with juvenile idiopathic arthritis: long-term results in pediatric secondary glaucoma].

作者信息

Wiese K, Heiligenhaus A, Heinz C

机构信息

Augenabteilung am St. Franziskus Hospital, Hohenzollernring 74, 48145, Münster, Deutschland,

出版信息

Ophthalmologe. 2014 Apr;111(4):330-8. doi: 10.1007/s00347-013-2888-9.

Abstract

BACKGROUND

Secondary uveitic glaucoma in children can only be controlled in many cases by surgery. The aim of this study was to evaluate the outcome of trabeculectomy (TE) with administration of mitomycin C in children with secondary uveitis associated with juvenile idiopathic arthritis (JIA).

MATERIALS AND METHODS

This study was a retrospective chart review of 21 children with uveitic glaucoma who underwent TE with administration of mitomycin C including analysis of complications, further interventions, additional surgical procedures to control intraocular pressure (IOP) and of the success rates after a mean follow-up of 5 years.

RESULTS

Defining success as an IOP ≤ 15 mmHg, the surgical success rate after TE was 55 % after 1 year and 38 % after 5 years but 43 % of the children required further IOP controlling operations in the long-term follow-up. An IOP ≤ 15 mmHg was observed in 70 % of the children after 1 year and in 62 % after 5 years. In regard to the overall success (with topical antiglaucomatous medication) the success rate increased to 71.4 % after 5 years.

CONCLUSIONS

The results show that TE is a suitable surgical procedure to control IOP in secondary uveitic glaucoma of JIA patients. In the long-term follow up additional postoperative adjustments are necessary to control the IOP.

摘要

背景

儿童继发性葡萄膜炎性青光眼在很多情况下只能通过手术来控制。本研究的目的是评估在患有与幼年特发性关节炎(JIA)相关的继发性葡萄膜炎的儿童中,小梁切除术(TE)联合丝裂霉素C给药的治疗效果。

材料与方法

本研究是一项对21例接受小梁切除术联合丝裂霉素C给药的葡萄膜炎性青光眼患儿的回顾性病历审查,包括对并发症、进一步干预措施、控制眼压(IOP)的额外手术程序以及平均随访5年后的成功率进行分析。

结果

将手术成功定义为眼压≤15 mmHg,小梁切除术后1年的手术成功率为55%,5年后为38%,但43%的儿童在长期随访中需要进一步进行眼压控制手术。1年后70%的儿童眼压≤15 mmHg,5年后为62%。就总体成功率(使用局部抗青光眼药物)而言,5年后成功率升至71.4%。

结论

结果表明,小梁切除术是控制JIA患者继发性葡萄膜炎性青光眼眼压的一种合适的手术方法。在长期随访中,需要进行额外的术后调整来控制眼压。

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