Mursch-Edlmayr Anna Sophie, Mojon Daniel S, Ring Michael, Laubichler Peter, Luft Nikolaus, Priglinger Siegfried Georg
Department of Ophthalmology, General Hospital (AKH), Johannes Kepler University; Ars Ophthalmica Study Center, General Hospital (AKH), Linz, Austria.
Department of Ophthalmology, General Hospital (AKH), Johannes Kepler University, Linz, Austria; Airport Medical Center Eye Clinic, Zürich, Switzerland.
Indian J Ophthalmol. 2016 Dec;64(12):914-918. doi: 10.4103/0301-4738.198863.
The aim of this study was to evaluate the safety and efficacy of deep sclerokeratodissection (DSKD), a new nonpenetrating technique in glaucoma surgery.
Retrospective comparison between patients treated with DSKS or deep sclerectomy (DS) between 2013 and 2014. In DSKD, the first and only flap is dissected directly into clear cornea with unroofing Schlemm's canal. Beside routine clinical follow-up (visual acuity, intraocular pressure [IOP] readings, slit lamp and fundus examination), postoperative ultrasound biomicroscopy (UBM) investigation and quality of life (QoL) assessment were performed. Statistically significant differences were determined by parametric or nonparametric tests, depending on normality.
Twelve (38.7%) DSKDs and 19 (61.3%) conventional DS' were included in this analysis. IOP decreased significantly from 21.5 ± 9.2 mmHg to 6.2 ± 5.4 mmHg on day 1, 13.4 ± 7.7 at 1 month, 12.0 ± 4.1 at 3 months, 12.5 ± 3.1 mmHg at 6 months, and 13.4 ± 4.3 mmHg at 12 months (P < 0.01). No significant difference in the IOP was observed between the two groups at any follow-up (P > 0.1). There was no significant difference in intra- and post-operative complications, the morphology of the surgical site in the UBM as well as in the QoL assessment.
The results indicate that DSKD is a safe and efficient new variant of nonpenetrating glaucoma surgery. IOP can be lowered as effectively compared to conventional DS, with a similarly low rate of complications. Further reports are necessary to confirm these results.
本研究旨在评估深层巩膜角膜切开术（DSKD）这一青光眼手术新的非穿透性技术的安全性和有效性。
对2013年至2014年间接受DSKD或深层巩膜切除术（DS）治疗的患者进行回顾性比较。在DSKD中，第一个也是唯一的瓣直接切开进入透明角膜并打开施莱姆管。除了常规临床随访（视力、眼压[IOP]测量、裂隙灯和眼底检查）外，还进行了术后超声生物显微镜（UBM）检查和生活质量（QoL）评估。根据数据的正态性，通过参数检验或非参数检验确定统计学上的显著差异。
本分析纳入了12例（38.7%）DSKD患者和19例（61.3%）传统DS患者。眼压在术后第1天从21.5±9.2 mmHg显著降至6.2±5.4 mmHg，1个月时为13.4±7.7 mmHg，3个月时为12.0±4.1 mmHg，6个月时为12.5±3.1 mmHg，12个月时为13.4±4.3 mmHg（P<0.01）。在任何随访中，两组间眼压均未观察到显著差异（P>0.1）。术中及术后并发症、UBM检查中手术部位的形态以及QoL评估方面均无显著差异。
结果表明DSKD是一种安全有效的非穿透性青光眼手术新术式。与传统DS相比，其降低眼压的效果相当，并发症发生率同样较低。需要进一步的报告来证实这些结果。
