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脉络膜上腔引流的巩膜造瘘术联合白内障手术的效果——1年结果

The effect of canaloplasty with suprachoroidal drainage combined with cataract surgery - 1-year results.

作者信息

Seuthe Anna-Maria, Januschowski Kai, Mariacher Siegfried, Ebner Martina, Opitz Natalia, Szurman Peter, Boden Karl

机构信息

Knappschaft Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany.

University Eye Clinic Tuebingen, Centre for Ophthalmology, Tuebingen, Germany.

出版信息

Acta Ophthalmol. 2018 Feb;96(1):e74-e78. doi: 10.1111/aos.13393. Epub 2017 Apr 27.

Abstract

PURPOSE

The purpose of this study was to investigate the safety and efficacy of phacocanaloplasty with suprachoroidal drainage (PCscD) and to compare its intraocular pressure (IOP)-lowering and drug-sparing effect to canaloplasty with suprachoroidal drainage (CscD).

METHODS

The study retrospective interventional study included patients with open-angle glaucoma or secondary forms of glaucoma who underwent either CscD or PCscD between the year 2011 and 2014 in Knappschaft Eye Clinic Sulzbach. Primary end-points were IOP reduction and the number of IOP-lowering medication after 12 months. Secondary end-points were intraoperative and postoperative complications.

RESULTS

A total of 328 eyes were included, 193 were treated with CscD and 135 underwent PCscD. Canaloplasty with scD achieved an IOP reduction of 37.0% (from 20.9 ± 3.6 mmHg to 13.2 ± 2.6 mmHg) after 1 year, whereas PCscD showed a significant higher reduction of 47.4% (from 23.2 ± 5.1 mmHg to 12.2 ± 1.7 mmHg). Reduction in IOP-lowering medication was higher after PCscD (from 3.6 ± 0.6 to 0.2 ± 0.5) than after CscD (from 3.5 ± 0.8 to 0.7 ± 1.0). Twelve months after surgery 55.5% in the CscD group and 80.2% in the PCscD group were free of IOP-lowering medication. In both groups, no severe or sight-threatening complications occurred.

CONCLUSION

Combining cataract surgery and CscD achieves a higher IOP reduction, and patients postoperatively need less IOP-lowering medication than after CscD alone.

摘要

目的

本研究旨在探讨经脉络膜上腔引流的晶状体囊袋成形术(PCscD)的安全性和有效性,并将其降低眼压(IOP)和减少药物使用的效果与经脉络膜上腔引流的睫状体成形术(CscD)进行比较。

方法

这项回顾性干预研究纳入了2011年至2014年在苏尔茨巴赫矿工眼科诊所接受CscD或PCscD治疗的开角型青光眼或继发性青光眼患者。主要终点是12个月后的眼压降低情况和降低眼压药物的使用数量。次要终点是术中及术后并发症。

结果

共纳入328只眼,其中193只接受CscD治疗,135只接受PCscD治疗。经脉络膜上腔引流的睫状体成形术在1年后眼压降低了37.0%(从20.9±3.6mmHg降至13.2±2.6mmHg),而PCscD显示出显著更高的降低幅度,为47.4%(从23.2±5.1mmHg降至12.2±1.7mmHg)。PCscD后降低眼压药物的减少幅度(从3.6±0.6降至0.2±0.5)高于CscD(从3.5±0.8降至0.7±1.0)。术后12个月,CscD组55.5%的患者和PCscD组80.2%的患者无需使用降低眼压药物。两组均未发生严重或威胁视力的并发症。

结论

白内障手术联合CscD可实现更高的眼压降低,且患者术后所需的降低眼压药物比单纯CscD术后更少。

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