Brusini Paolo, Caramello Guido, Benedetti Stefano, Tosoni Claudia
*Department of Ophthalmology, Azienda Ospedaliero-Universitaria "Santa Maria della Misericordia," Udine †Department of Ophthalmology, Azienda Ospedaliera Santa Croce e Carle, Cuneo ‡Villa Igea Eye Center, Ancona, Italy.
J Glaucoma. 2016 May;25(5):403-7. doi: 10.1097/IJG.0000000000000103.
To present the mid-term results of a prospective multicenter study on canaloplasty surgery in chronic open-angle glaucoma.
A total of 218 eyes from 197 patients with open-angle glaucoma under maximum tolerated medical therapy underwent canaloplasty within a time period of 42 months in 3 different Italian eye centers. All patients underwent a complete ophthalmic examination every 6 months. The follow-up ranged from 3 to 42 months.
The entire procedure according to standard protocol could not be performed in 20 eyes (9.2%). A total of 198 eyes from 178 patients with a mean follow-up of 23.1±10.6 months were taken into consideration. The preoperative mean intraocular pressure (IOP) was 28.4±7.5 mm Hg. The mean IOP at the 2-year follow-up was 15.9±4.7 mm Hg (range, 6 to 40 mm Hg; paired t test; P=0.0001), with a mean reduction from baseline of 44% (range, 11.1% to 82.8%). After 2 years of follow-up, a qualified success rate based on postoperative IOP≤21, ≤18, and ≤16 mm Hg was obtained in 82 (92.1%), 75 (84.3%), and 61 (68.5%) eyes, respectively; a complete success for an IOP≤21, ≤18, and ≤16 mm Hg was obtained in 63 (70.8%), 60 (67.4%), and 53 (59.5%) eyes, respectively. The number of medications used preoperatively and at the 2-year follow-up was 3.2±0.9 and 1.1±1.3, respectively. The most frequently seen complications included: hyphema in 47 eyes (23.7%), Descemet membrane detachment in 11 eyes (5.5%), and IOP spikes >10 mm Hg in 12 cases (6.1%).
Canaloplasty is a quite difficult surgical technique; however, mid-term results are promising. Complications can sometimes occur, but are seldom serious. The main advantage of this promising bleb-less procedure is that physiological humor aqueous outflow is restored.
介绍一项关于慢性开角型青光眼小梁切开术的前瞻性多中心研究的中期结果。
在意大利3个不同的眼科中心，197例接受最大耐受药物治疗的开角型青光眼患者共218只眼在42个月的时间内接受了小梁切开术。所有患者每6个月进行一次全面的眼科检查。随访时间为3至42个月。
20只眼（9.2%）未能按照标准方案完成整个手术。共纳入178例患者的198只眼，平均随访时间为23.1±10.6个月。术前平均眼压（IOP）为28.4±7.5 mmHg。2年随访时的平均眼压为15.9±4.7 mmHg（范围为6至40 mmHg；配对t检验；P = 0.0001），平均较基线降低44%（范围为11.1%至82.8%）。随访2年后，术后眼压≤21、≤18和≤16 mmHg时的合格成功率分别为82只眼（92.1%）、75只眼（84.3%）和61只眼（68.5%）；眼压≤21、≤18和≤16 mmHg时的完全成功率分别为63只眼（70.8%）、60只眼（67.4%）和53只眼（59.5%）。术前和2年随访时使用的药物数量分别为3.2±0.9和1.1±1.3。最常见的并发症包括：47只眼（23.7%）出现前房积血，11只眼（5.5%）出现后弹力层脱离，12例（6.1%）出现眼压升高>10 mmHg。
小梁切开术是一项相当困难的手术技术；然而，中期结果令人鼓舞。并发症有时会发生，但很少严重。这种有前景的无滤过泡手术的主要优点是恢复了生理性房水流出。
