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小梁切开联合丝裂霉素C的粘小管成形术治疗原发性先天性青光眼

Viscocanalostomy combined with trabeculotomy and mitomycin C in the treatment of primary congenital glaucoma.

作者信息

Qian Chao-Xu, Zong Yuan, Chen Qin, Yuan Zhi-Lan

机构信息

Department of Ophthalmology, the Third People's Hospital of Changzhou, Changzhou 213001, Jiangsu Province, China.

Department of Ophthalmology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China.

出版信息

Int J Ophthalmol. 2017 Jun 18;10(6):919-924. doi: 10.18240/ijo.2017.06.14. eCollection 2017.

DOI:10.18240/ijo.2017.06.14
PMID:28730083
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5515151/
Abstract

AIM

To evaluate the long-term outcome of viscocanalostomy combined with trabeculotomy and mitomycin C in the treatment of primary congenital glaucoma.

METHODS

This is a retrospective study. Forty-two eyes of 26 patients with primary congenital glaucoma were enrolled. Intraocular pressure (IOP), corneal diameter (mm) and cup/disc (C/D) were measured before and after the surgery respectively. Follow-up period was 30mo.

RESULTS

The mean preoperative IOP was 30.6±7.35 mm Hg. Of the 42 eyes, 2 eyes were required conversion to trabeculectomy for the absence of Schlemm's canal. Of remained 40 eyes, 38 eyes (95%) achieved successful IOP control. The average postoperative IOP was 11.69±4.18 mm Hg at 12mo. The mean reduction was 18.91 mm Hg (<0.0001). Eighteen (75%) eyes presented a reduction in corneal diameter, and 25 (62.5%) eyes presented a C/D ratio reversal after the surgery. There was no serious complication in any patients over the follow-up period.

CONCLUSION

Viscocanalostomy combined with trabeculotomy and mitomycin C is useful in the management of primary congenital glaucoma.

摘要

目的

评估粘小管切开术联合小梁切开术及丝裂霉素C治疗原发性先天性青光眼的长期疗效。

方法

这是一项回顾性研究。纳入26例原发性先天性青光眼患者的42只眼。分别在手术前后测量眼压(IOP)、角膜直径(mm)及杯盘比(C/D)。随访期为30个月。

结果

术前平均眼压为30.6±7.35 mmHg。42只眼中,2只眼因未找到施莱姆管而改行小梁切除术。其余40只眼中,38只眼(95%)眼压控制成功。术后12个月平均眼压为11.69±4.18 mmHg。平均降低18.91 mmHg(<0.0001)。18只眼(75%)术后角膜直径缩小,25只眼(62.5%)术后杯盘比逆转。随访期间所有患者均无严重并发症。

结论

粘小管切开术联合小梁切开术及丝裂霉素C对原发性先天性青光眼的治疗有效。

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本文引用的文献

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Long-term surgical outcome of conventional trabeculotomy for childhood glaucoma.儿童青光眼传统小梁切开术的长期手术效果
Jpn J Ophthalmol. 2017 May;61(3):237-244. doi: 10.1007/s10384-017-0506-0. Epub 2017 Mar 16.
2
Outcomes of microcatheter-assisted trabeculotomy following failed angle surgeries in primary congenital glaucoma.原发性先天性青光眼房角手术失败后微导管辅助小梁切开术的疗效
Eye (Lond). 2017 Jan;31(1):132-139. doi: 10.1038/eye.2016.212. Epub 2016 Oct 14.
3
Endophthalmitis Associated With Glaucoma Drainage Implants.与青光眼引流植入物相关的眼内炎
Ophthalmic Surg Lasers Imaging Retina. 2016 Jun 1;47(6):563-9. doi: 10.3928/23258160-20160601-08.
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Review on the Management of Primary Congenital Glaucoma.原发性先天性青光眼的管理综述
J Curr Glaucoma Pract. 2015 Sep-Dec;9(3):92-9. doi: 10.5005/jp-journals-10008-1192. Epub 2016 Feb 2.
5
Biodegradable collagen matrix implant versus mitomycin-C in trabeculectomy: five-year follow-up.小梁切除术中可生物降解胶原蛋白基质植入物与丝裂霉素C的比较:五年随访
BMC Ophthalmol. 2016 Mar 5;16:24. doi: 10.1186/s12886-016-0198-0.
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Trabeculectomy-related complications in Olmsted County, Minnesota, 1985 through 2010.1985 年至 2010 年明尼苏达州奥姆斯特德县小梁切除术相关并发症。
JAMA Ophthalmol. 2015 May;133(5):574-80. doi: 10.1001/jamaophthalmol.2015.57.
7
Illuminated microcatheter circumferential trabeculotomy versus combined trabeculotomy-trabeculectomy for primary congenital glaucoma: a randomized controlled trial.原发性先天性青光眼的照明微导管环形小梁切开术与小梁切开术-小梁切除术联合治疗:一项随机对照试验
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