Wang Huaizhou, Xin Chen, Han Ying, Shi Yan, Ziaei Sarah, Wang Ningli
Beijing Tongren Eye center, Beijing Tongren Hospital, Capital medical university, Beijing, China.
Department of Ophthalmology, University of California, San Francisco School of Medicine, San Francisco, California, USA.
BMC Ophthalmol. 2020 Oct 2;20(1):389. doi: 10.1186/s12886-020-01645-0.
To compare the efficacy and safety of ab externo circumferential trabeculotomy (ECT) and canaloplasty on primary open angle glaucoma (POAG) patients with failed filtering surgery and intact schlemm's canal (SC).
We conducted a retrospective chart review of POAG patients with failed filtering surgery and intact SC, who further received ECT and canaloplasty. The primary outcome measures were intraocular pressure (IOP) and the number of topical medications at each follow-up point. The secondary outcome compared the quantified success rate at1-year follow-up between the groups.
Twenty-nine eyes were recruited in the ECT group and 19 eyes in canaloplasty group. The postoperative IOP and the number of topical medications decreased significantly in both groups (p < 0.001). The IOP at 3-month and 6-monthwas significantly lower in the ECT group (p = 0.039, p = 0.001) than in the canaloplasty group. Although the IOP at 12-mon was similar between the two groups, the number of topical medications was less in the ECT group (p = 0.040). Hyphema (72.4%) and ciliary body detachment (27.6%), which mainly resolve spontaneously, were two leading complications in the ECT group. The prevalence of hyphema was higher in ECT than in canaloplasty group (p < 0.001).
For POAG with failed filtering surgery and intact SC, canaloplasty may be safer, whereas ECT presented better IOP control. Translational Relevance: Suggestions for surgical choice for POAG with failed filtering surgery.
比较外路环形小梁切开术（ECT）和前房角成形术对滤过手术失败且施莱姆管（SC）完整的原发性开角型青光眼（POAG）患者的疗效和安全性。
我们对滤过手术失败且SC完整的POAG患者进行了回顾性病历审查，这些患者进一步接受了ECT和前房角成形术。主要观察指标为各随访点的眼压（IOP）和局部用药次数。次要观察指标比较了两组在1年随访时的量化成功率。
ECT组纳入29只眼，前房角成形术组纳入19只眼。两组术后IOP和局部用药次数均显著降低（p < 0.001）。ECT组3个月和6个月时的IOP显著低于前房角成形术组（p = 0.039，p = 0.001）。虽然两组12个月时的IOP相似，但ECT组的局部用药次数较少（p = 0.040）。前房积血（72.4%）和睫状体脱离（27.6%）是ECT组的两个主要并发症，主要为自行消退。ECT组前房积血的发生率高于前房角成形术组（p < 0.001）。
对于滤过手术失败且SC完整的POAG，前房角成形术可能更安全，而ECT在控制IOP方面表现更佳。转化相关性：为滤过手术失败的POAG的手术选择提供建议。
