深层巩膜切除术治疗葡萄膜炎性青光眼的疗效与安全性长期评估
Long-term evaluation of efficacy and safety of deep sclerectomy in uveitic glaucoma.
作者信息
Al Obeidan Saleh A, Osman Essam A, Mousa Ahmed, Al-Muammar Abdulrahman M, Abu El-Asrar Ahmed M
机构信息
Department of Ophthalmology, College of Medicine, King Saud University , Riyadh , Saudi Arabia.
出版信息
Ocul Immunol Inflamm. 2015 Feb;23(1):82-9. doi: 10.3109/09273948.2013.870213. Epub 2014 Jan 10.
PURPOSE
To assess long-term efficacy and safety of deep sclerectomy (DS) in uveitic glaucoma.
PATIENTS AND METHODS
Thirty-three consecutive eyes (21 patients) with uveitic glaucoma underwent DS with mitomycin C and implant. Goniopuncture (GP) was done for uncontrolled postoperative intraocular pressure (IOP).
RESULTS
Mean (± SD) follow-up was 33.2 (± 19.8) months. IOP was reduced from a mean preoperative value of 37.2 to postoperative value of 14.7 mmHg (p < 0.0001). Complete success was achieved in 24/33 eyes (72.7%); qualified success was obtained in 7/33 eyes (21.2%). Neodymium:YAG GP was performed in 12 eyes. Postoperative complications included cataract progression in 9 eyes, transient hypotony in 6 eyes, shallow choroidal effusions in 4 eyes, hypotony with persistent maculopathy in 1 eye, hyphema in 1 eye, and decompression retinopathy in 1 eye.
CONCLUSION
DS is safe and effective in patients with uveitic open-angle glaucoma. However, laser goniopuncture is frequently needed to improve the outcome.
目的
评估深层巩膜切除术（DS）治疗葡萄膜炎性青光眼的长期疗效和安全性。
患者与方法
连续33只眼（21例患者）的葡萄膜炎性青光眼接受了含丝裂霉素C的DS及植入物植入术。对于术后眼压（IOP）控制不佳的患者进行了前房角穿刺（GP）。
结果
平均（±标准差）随访时间为33.2（±19.8）个月。眼压从术前平均37.2 mmHg降至术后14.7 mmHg（p < 0.0001）。33只眼中24只（72.7%）获得完全成功；7只眼（21.2%）获得合格成功。12只眼进行了钕：钇铝石榴石激光前房角穿刺。术后并发症包括9只眼白内障进展、6只眼短暂性低眼压、4只眼脉络膜浅脱离、1只眼低眼压伴持续性黄斑病变、1只眼前房积血和1只眼减压性视网膜病变。
结论
DS治疗葡萄膜炎性开角型青光眼安全有效。然而，常需要激光前房角穿刺来改善治疗效果。
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