Sheng Lim Kin, Garg Anurag, Cheng Jason, Muthusamy Kirithika, Beltran-Agullo Laura, Barton Keith
Consultant, Department of Ophthalmology, Guys & St Thomas' NHS Foundation Trust, London, United Kingdom.
Specialist Registrar, Department of Ophthalmology, Glaucoma Service, St Thomas' Hospital, London, United Kingdom.
J Curr Glaucoma Pract. 2018 Jan-Apr;12(1):36-39. doi: 10.5005/jp-journals-10028-1241. Epub 2018 Mar 1.
To compare the early postoperative hypotony rates and intraocular pressure (IOP) in two groups of eyes using either 23-gauge (23G) or 25-gauge (25G) needle in the creation of the anterior chamber entry tract for Baerveldt tube. The primary outcome measure was incidence of hypotony, and secondary outcome measures included comparison of mean IOP and other early complications.
Ours was a retrospective case review of consecutive patients who underwent 350 mm Baerveldt implantation in two units over a 2-year period. Data including IOP and complications were collected at 1 day, 1 week, and 1 month following surgery from patients' notes. Statistical analysis between groups was determined using the unpaired 2-tailed f-test for continuous variables and chi-squared test for categorical variables. Statistical significance was defined at the 0.05 level.
A total of 58 eyes of 58 patients were included in this study. Preoperative mean IOP in the 25G group was significantly higher (26.4 ± 6.8 mm Hg) when compared with the 23G group (21.6 ± 4.0 mm Hg) (p = 0.002). The mean postoperative IOP remained significantly higher in the 25G group at day 1 (p=0.004), week 1 (p = 0.008), but not at month 1 (p = 0.744). Four patients in the 23G group had hypotony within 1 month postsurgery compared with no cases in the 25G group (chi-squared test p = 0.038).
There was a significantly higher risk of early hypotony and lower IOP in the larger 23G group at days 1 and 7, although the IOP was similar in both groups by 1 month.
After all glaucoma drainage device (GDD) tube implantation, regardless of which needle is used to create the tract, the entry site should always be checked with 2% fluorescein drop and 10.0 nylon suture is used with or without autologous Tenon's tissue to close any leakage. Lim KS, Garg A, Cheng J, Muthusamy K, Beltran-Agullo L, Barton K. Comparison of Short-term Postoperative Hypotony Rates of 23-gauge 25-gauge Needles in Formation of the Scleral Tract for Baerveldt Tube Insertion into the Anterior Chamber. J Curr Glaucoma Pract 2018;12(1):36-39.
比较两组使用23号（23G）或25号（25G）针头创建用于Baerveldt管的前房进入通道的眼睛术后早期低眼压率和眼压（IOP）。主要观察指标是低眼压的发生率，次要观察指标包括平均眼压的比较和其他早期并发症。
我们对在两年内两个科室连续接受350mm Baerveldt植入术的患者进行了回顾性病例研究。术后1天、1周和1个月时从患者病历中收集包括眼压和并发症的数据。组间统计分析采用连续变量的非配对双尾f检验和分类变量的卡方检验。统计学显著性定义为0.05水平。
本研究共纳入58例患者的58只眼睛。25G组术前平均眼压（26.4±6.8mmHg）显著高于23G组（21.6±4.0mmHg）（p = 0.002）。25G组术后第1天（p = 0.004）、第1周（p = 0.008）平均眼压仍显著较高，但第1个月时无差异（p = 0.744）。23G组有4例患者在术后1个月内发生低眼压，而25G组无此情况（卡方检验p = 0.038）。
在术后第1天和第7天，较大的23G组早期低眼压风险显著更高，眼压更低，尽管两组在1个月时眼压相似。
在所有青光眼引流装置（GDD）管植入后，无论使用哪种针头创建通道，均应使用2%荧光素滴眼液检查进入部位，并使用10.0尼龙缝线，无论有无自体Tenon组织，以封闭任何渗漏。Lim KS、Garg A、Cheng J、Muthusamy K、Beltran-Agullo L、Barton K。23号与25号针头在Baerveldt管插入前房巩膜通道形成中术后短期低眼压率的比较。《当代青光眼实践杂志》2018年；12(1):36 - 39。
