原发性开角型青光眼滤过手术失败后行巩膜切开术与原发性巩膜切开术的一年期中期比较。

One-year interim comparison of canaloplasty in primary open-angle glaucoma following failed filtering surgery with primary canaloplasty.

作者信息

Xin Chen, Chen Xiaoya, Shi Yan, Li Meng, Wang Huaizhou, Wang Ningli

机构信息

Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Department of Ophthalmology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

Br J Ophthalmol. 2016 Dec;100(12):1692-1696. doi: 10.1136/bjophthalmol-2015-308219. Epub 2016 Apr 8.

DOI:10.1136/bjophthalmol-2015-308219

PMID:27060163

Abstract

BACKGROUND/AIMS: This study was to explore the 1-year interim efficacy and safety of canaloplasty for primary open-angle glaucoma (POAG) with failed glaucoma filtration surgery (GFS) but an intact Schlemm's canal (SC).

METHODS

This was a single-surgeon prospective clinical study. Patients with POAG scheduled for canaloplasty were included and divided into two groups (with or without failed GFS). The status of SC was determined by gonioscopy and ultrasound biomicroscopy. Primary outcome measures included intraocular pressure (IOP) and glaucoma medication use at various follow-up points. The secondary outcome measure was the rate of surgical success.

RESULTS

Thirty-seven eyes were enrolled in group 1 (no GFS) and 23 eyes were enrolled in group 2 (failed GFS). The mean IOP (16.0±1.6 vs 16.2±1.6 mm Hg) and the number of medications (0.3±0.8 vs 0.3±0.6) at 18 months after canaloplasty were not significantly different between the two groups. There was no significant difference in complete success rate (criteria A: 52.2% vs 59.5%, p=0.587; criteria B: 39.1% vs 48.6%, p=0.343), as well as the qualified success rate (criteria A: 86.5% vs 82.6%, p=0.668; criteria B: 78.4% vs 69.6%, p=0.445). In group 2, the age, sex, number of previous surgeries, time span between operations were not significantly associated with surgery failure (p=0.199, 0.747, 0.977 and 0.615). Hyphaema was the most common postoperative complications.

CONCLUSIONS

Canaloplasty is an effective and safe option for POAG with failed GFS but an intact SC.

TRIAL REGISTRATION NUMBER

ChiCTR-ICR-15005788, Results.

摘要

背景/目的：本研究旨在探讨针对原发性开角型青光眼（POAG）且青光眼滤过手术（GFS）失败但施莱姆管（SC）完整的患者，行小梁切开术的1年中期疗效和安全性。

方法

这是一项由单一外科医生进行的前瞻性临床研究。纳入计划行小梁切开术的POAG患者，并分为两组（GFS失败组和未失败组）。通过前房角镜检查和超声生物显微镜检查确定SC的状态。主要观察指标包括不同随访时间点的眼压（IOP）和青光眼药物使用情况。次要观察指标为手术成功率。

结果

第1组（未行GFS）纳入37只眼，第2组（GFS失败）纳入23只眼。小梁切开术后18个月时，两组的平均眼压（16.0±1.6 vs 16.2±1.6 mmHg）和药物数量（0.3±0.8 vs 0.3±0.6）无显著差异。完全成功率（标准A：52.2% vs 59.5%，p = 0.587；标准B：39.1% vs 48.6%，p = 0.343）以及合格成功率（标准A：86.5% vs 82.6%，p = 0.668；标准B：78.4% vs 69.6%，p = 0.445）均无显著差异。在第2组中，年龄、性别、既往手术次数、两次手术之间的时间间隔与手术失败无显著相关性（p = 0.199、0.747、0.977和0.615）。前房积血是最常见的术后并发症。