Kunikata Hiroshi, Aizawa Naoko, Fuse Nobuo, Abe Toshiaki, Nakazawa Toru
Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University Graduate School of Medicine, Sendai 980-8573, Japan.
J Ophthalmol. 2014;2014:306814. doi: 10.1155/2014/306814. Epub 2014 Apr 22.
Purpose. To determine the feasibility of using 25-gauge microincision vitrectomy surgery (25GMIVS) to treat vitreoretinal disease in glaucomatous eyes which have previously undergone trabeculectomy (TLE). Methods. A consecutive, interventional case series. We performed 25GMIVS in 15 glaucomatous eyes that had undergone TLE. Follow-up period was 11.5 months. Results. 25GMIVS was successfully used and led to improvement in visual acuity (P < 0.01). We performed 25GMIVS for proliferative diabetic retinopathy with neovascular glaucoma in 53% of eyes (8 of 15). Although 3 eyes needed further TLE following 25GMIVS, final IOP was below 21 mmHg in all eyes except one eye (93%) and was comparable to pre-25GMIVS IOP (P = 0.20) without an increase in the number of glaucoma medications (P = 0.14). Conclusions. 25GMIVS is a feasible treatment for vitreoretinal disease in eyes with preexisting TLE, effective in both significantly improving BCVA and preserving the filtering bleb, while not excluding further glaucoma surgery.
目的。确定使用25G微切口玻璃体切除术（25GMIVS）治疗先前已接受小梁切除术（TLE）的青光眼患者的玻璃体视网膜疾病的可行性。方法。一项连续的干预性病例系列研究。我们对15只已接受TLE的青光眼患眼进行了25GMIVS。随访期为11.5个月。结果。成功应用25GMIVS并使视力得到改善（P < 0.01）。53%的患眼（15只中的8只）因增殖性糖尿病视网膜病变合并新生血管性青光眼接受了25GMIVS。尽管3只眼在25GMIVS后需要进一步的TLE，但除1只眼外，所有患眼的最终眼压均低于21 mmHg（93%），且与25GMIVS前的眼压相当（P = 0.20），青光眼药物使用数量未增加（P = 0.14）。结论。25GMIVS是治疗已有TLE患眼的玻璃体视网膜疾病的一种可行方法，在显著提高最佳矫正视力（BCVA）和保留滤过泡方面均有效，同时不排除进一步的青光眼手术。
