Qing Guo-Ping, Wang Ning-Li, Wang Tao, Chen Hong, Mou Da-Peng
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China.
Chin Med J (Engl). 2016 Jun 5;129(11):1268-72. doi: 10.4103/0366-6999.182825.
Though trabeculectomy is often performed on patients with medically refractive pigmentary glaucoma (PG), the clinical outcomes of surgical treatment on PG remain unknown. The aim of this study was to summarize the long-term efficacy and safety of trabeculectomy on PG.
This was a prospective case series observational study. Eighteen consecutive PG patients were followed up for 8 years after trabeculectomy from May 2006 to April 2007. Visual acuity (VA), best-corrected visual acuity (BCVA), slit lamp biomicroscopy, intraocular pressure (IOP) measurement, Humphrey visual field analysis (VFA), and stereoscopic funduscopy were performed on admission and every 6 months after the surgery. Postoperative IOP, VA, BCVA, VFA, adjunctive anti-glaucoma medication, treatment-related side-effects, changes in blebs, and main clinical findings in the anterior segment of PG were recorded and compared with the baseline.
Eighteen PG eyes from 18 patients, with average preoperative IOP of 34.5 ± 4.7 mmHg (range: 21-47 mmHg, 1 mmHg=0.133 kPa) were enrolled in this study. All enrolled patients completed the follow-up visits and required examinations. Eight years after trabeculectomy, all surgical eyes (18/18) had satisfactory IOP control with an average of 13.7 ± 2.5 mmHg (range: 9-19 mmHg), which was significantly lower than baseline (P = 0.001). Majority (15/18) of the PG eyes had stable VA, BCVA, VFA, and optic disc cupping parameters. Functional blebs still existed in 12/18 of the PG eyes at the last follow-up visit. Unanimously, pigmentation in the anterior segment attenuated with time after surgical treatment. No severe side-effects were recorded in any of the surgical eyes.
All surgical PG eyes in this study had satisfactory IOP control 8 years after the surgery with well-preserved visual function. The long-term efficacy and safety of trabeculectomy are promising in PG patients.
尽管小梁切除术常用于药物治疗效果不佳的色素性青光眼（PG）患者，但手术治疗PG的临床疗效仍不明确。本研究旨在总结小梁切除术治疗PG的长期疗效和安全性。
这是一项前瞻性病例系列观察研究。对2006年5月至2007年4月期间连续18例接受小梁切除术的PG患者进行了8年的随访。入院时及术后每6个月进行视力（VA）、最佳矫正视力（BCVA）、裂隙灯生物显微镜检查、眼压（IOP）测量、Humphrey视野分析（VFA）和立体眼底镜检查。记录术后眼压、视力、最佳矫正视力、视野分析、辅助抗青光眼药物、治疗相关副作用、滤过泡变化以及PG眼前节的主要临床发现，并与基线进行比较。
本研究纳入了18例患者的18只PG眼，术前平均眼压为34.5±4.7 mmHg（范围：21 - 47 mmHg，1 mmHg = 0.133 kPa）。所有纳入患者均完成了随访和所需检查。小梁切除术后8年，所有手术眼（18/18）眼压控制良好，平均眼压为13.7±2.5 mmHg（范围：9 - 19 mmHg），显著低于基线（P = 0.001）。大多数（15/18）PG眼的视力、最佳矫正视力、视野分析和视盘杯盘比参数保持稳定。最后一次随访时，12/18的PG眼仍存在功能性滤过泡。手术治疗后，眼前节色素沉着均随时间减轻。所有手术眼均未记录到严重副作用。
本研究中所有接受手术的PG眼术后8年眼压控制良好，视功能保存良好。小梁切除术在PG患者中的长期疗效和安全性前景良好。
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