Lan Jie, Sun Da-Peng, Wu Jie, Wang Ya-Ni, Xie Li-Xin
Qingdao University Medical College, Qingdao 266071, Shandong Province, China; Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.
Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.
Int J Ophthalmol. 2017 Jan 18;10(1):51-55. doi: 10.18240/ijo.2017.01.08. eCollection 2017.
To compare the long-term outcomes of the Ex-PRESS miniature glaucoma device implanted under a scleral flap in combination of phacoemulsification with intraocular lens implantation in primary open angle glaucoma (POAG) and chronic primary angle-closure glaucoma (CPACG).
Retrospective, comparative study. A total of 60 eyes (60 patients) receiving the Ex-PRESS miniature glaucoma device implantation combined with phacoemulsification were reviewed. Thirty eyes (30 patients) had the combined procedures for POAG, and the other 30 eyes (30 patients) for CPACG.
The follow-up was 39.37±7.09mo (range 3 to 49mo) in patients with POAG and 37.10±9.26mo (range 9 to 49mo) in patients with CPACG (=0.29). The mean change in best corrected visual acuity was 0.41 logMAR for POAG and 0.38 logMAR for CPACG at the last follow-up (=0.22). The postoperative intraocular pressure (IOP) of the POAG group was significantly lower than the CPACG group at 1, 3, 12, and 18mo after surgery (=0.02, 0.00, 0.04, 0.01) with similar glaucoma medications after surgery (>0.16). At 3y after surgery, the cumulative complete and qualified success rates were 63.3% (POAG) and 53.3% (CPACG), 83.3% (POAG) and 73.3% (CPACG) (=0.41, 0.49), respectively. The POAG group had more hypotony than the CPACG group (=0.04).
The long-term outcomes show the Ex-PRESS implantation combined with phacoemulcification can effectively lower the IOP in both the POAG and CPACG groups. The POAG group seems to have lower postoperative IOP and a higher risk of hypotony.
比较在巩膜瓣下植入Ex-PRESS微型青光眼引流器联合白内障超声乳化吸除及人工晶状体植入术治疗原发性开角型青光眼（POAG）和慢性原发性闭角型青光眼（CPACG）的长期疗效。
回顾性、对照研究。共纳入60例（60只眼）接受Ex-PRESS微型青光眼引流器植入联合白内障超声乳化吸除术的患者。其中30例（30只眼）为POAG患者接受联合手术，另外30例（30只眼）为CPACG患者接受联合手术。
POAG患者随访时间为39.37±7.09个月（范围3至49个月），CPACG患者随访时间为37.10±9.26个月（范围9至49个月）（P=0.29）。末次随访时，POAG患者最佳矫正视力平均变化为0.41 logMAR，CPACG患者为0.38 logMAR（P=0.22）。术后1、3、12和18个月，POAG组术后眼压显著低于CPACG组（P=0.02、0.00、0.04、0.01），术后使用的青光眼药物相似（P>0.16）。术后3年，POAG组和CPACG组的累计完全成功率和有效成功率分别为63.3%（POAG）和53.3%（CPACG）、83.3%（POAG）和73.3%（CPACG）（P=0.41、0.49）。POAG组低眼压发生率高于CPACG组（P=0.04）。
长期疗效显示，Ex-PRESS植入联合白内障超声乳化吸除术可有效降低POAG组和CPACG组的眼压。POAG组术后眼压似乎更低，但发生低眼压的风险更高。
