非穿透性深层巩膜切除术治疗进展性青光眼：眼压控制和视野存活的长期（5年）随访
Nonpenetrating Deep Sclerectomy for Progressive Glaucoma: Long-term (5-year) Follow-up of Intraocular Pressure Control and Visual Field Survival.
作者信息
Slagle Grant, Groth Sylvia L, Montelongo Mario, Sponsel William E
机构信息
Chicago College of Osteopathic Medicine, Midwestern University, Westmont, Illinois, USA.
Department of Ophthalmology Glaucoma Service, Vanderbilt University, Nashville, Tennessee, USA.
出版信息
J Curr Glaucoma Pract. 2020 Jan-Apr;14(1):3-9. doi: 10.5005/jp-journals-10078-1273.
PURPOSE
To monitor 5-year outcomes of nonpenetrating deep sclerectomy (NPDS) with mitomycin C (MMC) in a new consecutive patient cohort.
MATERIALS AND METHODS
All eyes undergoing NPDS surgery between 1/08 and 6/12 were monitored for intraocular pressure (IOP), number of antiglaucoma medications (meds), and visual field indices [mean deviation (MD) and corrected pattern standard deviation (CPSD)], relative to the preoperative baseline using the two-tailed paired Student's test.
RESULTS
Of 106 eyes undergoing NPDS with MMC, mean IOP was 19.7 ± 0.5 [sem] mm Hg preoperatively, 11.9 ± 0.5 at 3 months, 12.5 ± 0.6 at 6 months, 12.4 ± 0.5 at 12 months, 12.6 ± 0.6 at 18 months, 11.1 ± 0.6 at 2 years, 11.8 ± 0.5 at 2.5 years, 11.0 ± 0.5 at 3 years, 11.7 ± 0.5 at 3.5 years, 10.7 ± 0.7 at 4 years, 11.6 ± 0.5 at 4.5 years, and 12.4 ± 0.7 at 5 years (average IOP reduction of 7.8 mm Hg or 37%; < 10) at 5 years. About 92% of eyes had stable IOP ≥5 and ≤21 mm Hg at 5 years. Mean preoperative meds 2.7 ± 0.1 was reduced to 0.40 ±0.09 at 3 months, 0.51 ± 0.1 at 6 months, 0.38 ± 0.08 at 12 months, 0.49 ± 0.09 at 18 months, 0.41 ± 0.09 at 2 years, 0.39 ± 0.09 at 2.5 years, 0.49 ± 0.1 at 3 years, 0.58 ± 0.1 at 3.5 years, 0.49 ± 0.1 at 4 years, 0.64 ± 0.1 at 4.5 years, and 0.52 ± 0.1 at 5 years, corresponding to mean reduction of 2.2 meds (81%; < 10) at 5 years. Mean deviation and CPSD were stable relative to baseline at all time intervals ( = 0.83-0.94; < 0.0001).
CONCLUSION
With appropriate postoperative management, eyes undergoing NPDS can maintain excellent IOP control with minimal medication use and maintain very stable visual fields over an extended time frame.
HOW TO CITE THIS ARTICLE
Slagle G, Groth SL, Montelongo M, Nonpenetrating Deep Sclerectomy for Progressive Glaucoma: Long-term (5-year) Follow-up of Intraocular Pressure Control and Visual Field Survival. J Curr Glaucoma Pract 2020;14(1):3-9.
目的
在一个新的连续患者队列中监测使用丝裂霉素C（MMC）的非穿透性深层巩膜切除术（NPDS）的5年疗效。
材料与方法
对2008年1月至2012年6月期间接受NPDS手术的所有眼睛进行监测，记录眼压（IOP）、抗青光眼药物数量（meds）和视野指标[平均偏差（MD）和校正模式标准偏差（CPSD）]，并使用双尾配对学生t检验将其与术前基线进行比较。
结果
在106只接受MMC辅助NPDS手术的眼中，术前平均IOP为19.7±0.5[标准误]mmHg，3个月时为11.9±0.5，6个月时为12.5±0.6，12个月时为12.4±0.5，18个月时为12.6±0.6，2年时为11.1±0.6，2.5年时为11.8±0.5，3年时为11.0±0.5，3.5年时为11.7±0.5，4年时为10.7±0.7，4.5年时为11.6±0.5，5年时为12.4±0.7（5年时平均IOP降低7.8mmHg或37%；P<0.0001）。5年时约92%的眼睛IOP稳定在≥５且≤21mmHg。术前平均药物数量为2.7±0.1，3个月时降至0.40±0.09，6个月时为0.51±0.1，12个月时为0.38±0.08，18个月时为0.49±0.09，2年时为0.41±0.09，2.5年时为0.39±0.09，3年时为0.49±0.1，3.5年时为0.58±0.1，4年时为0.49±0.1，4.5年时为0.64±0.1，5年时为0.52±0.1，5年时平均减少2.2种药物（81%；P<0.0001）。在所有时间间隔内，平均偏差和CPSD相对于基线均保持稳定（P=0.83 - 0.94；P<0.0001）。
结论
通过适当的术后管理，接受NPDS手术的眼睛能够以最少的药物使用维持良好的眼压控制，并在较长时间内保持非常稳定的视野。
如何引用本文
Slagle G, Groth SL, Montelongo M, 非穿透性深层巩膜切除术治疗进展性青光眼：眼压控制和视野存活的长期（5年）随访。《当代青光眼实践杂志》2020年；14(1):3 - 9。
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