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改良小梁切除术与青光眼引流植入术治疗难治性青光眼的回顾性比较研究。

Modified Trabeculectomy versus Glaucoma Drainage Implant Surgery: A Retrospective Comparative Study for Refractory Glaucoma Treatment.

机构信息

Department of Ophthalmology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, 710038 Shaanxi Province, China.

Department of Ophthalmology, Fufeng County People's Hospital, Baoji, 722299 Shaanxi Province, China.

出版信息

Oxid Med Cell Longev. 2022 May 23;2022:3050007. doi: 10.1155/2022/3050007. eCollection 2022.

DOI:10.1155/2022/3050007
PMID:35651730
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9150991/
Abstract

PURPOSE

To observe and compare the efficacy of modified trabeculectomy (TE), Ahmed drainage valve implantation (AGV), and EX-PRESS glaucoma shunt for refractory glaucoma (RG).

METHODS

The study population of this retrospective study comprised 73 patients (76 eyes) who were suffering from RG and treated with modified TE, AGV, and EX-PRESS glaucoma shunt in our hospital from October 2012 to October 2020. The number of cases who underwent modified TE, AVG, and EX-PRESS glaucoma shunt was 36 (38 eyes). 19 (20 eyes), and 18 patients (18 eyes), respectively. The intraocular pressure (IOP), best-corrected visual acuity (BCVA), postoperative antiglaucoma medications, filter bubble morphology, anterior chamber depth (ACD), successful rate, and postoperative complications were recorded and statistically analyzed preoperative and 1 d, 1 w, 1 mon, 3 mon, 6 mon, and the end follow-up after operation.

RESULTS

The BCVA differed insignificantly among the three cohorts before and 6 months after surgery. Compared to preoperative BCVA, the postoperative BCVA of the three groups had no statistical significance. An obvious reduction in IOP was observed in all the three group after operation ( < 0.05). An obvious decrease in antiglaucoma medications was observed after surgery in all the three groups ( < 0.05). The AGV group showed deeper ACD postoperatively, while no marked difference was found in postoperative ACD in the other two groups. The total success rates in modified TE and AGV groups were slightly higher than those in the EX-PRESS group. The three groups differed insignificantly in filter bubble morphology after operation.

CONCLUSION

Modified TE, AGV, and EX-PRESS glaucoma shunt showed equivalent efficacy for RG, which could validly reduce IOP and postoperative antiglaucoma medications. However, the success rates of modified TE and AGV were slightly higher than those of EX-PRESS glaucoma shunt in the last follow-up, and their complications were slightly less than those of the EX-PRESS glaucoma shunt.

摘要

目的

观察比较改良小梁切除术（TE）、 Ahmed 引流阀植入术（AGV）和 EX-PRESS 青光眼引流阀治疗难治性青光眼（RG）的疗效。

方法

回顾性研究纳入 2012 年 10 月至 2020 年 10 月在我院接受改良 TE、AGV 和 EX-PRESS 青光眼引流阀治疗的 RG 患者 73 例（76 眼）。改良 TE、AVG 和 EX-PRESS 青光眼引流阀治疗的患者分别为 36 例（38 眼）、19 例（20 眼）和 18 例（18 眼）。记录并比较患者术前及术后 1d、1w、1mon、3mon、6mon 和末次随访时的眼压（IOP）、最佳矫正视力（BCVA）、术后抗青光眼药物使用情况、滤过泡形态、前房深度（ACD）、成功率及术后并发症。

结果

术后 6 个月，三组患者的 BCVA 术前比较差异无统计学意义。与术前 BCVA 相比，三组术后 BCVA 差异均无统计学意义。三组术后 IOP 均明显降低（ < 0.05）。三组术后抗青光眼药物使用量均明显减少（ < 0.05）。AGV 组术后 ACD 较深，而另外两组术后 ACD 无明显差异。改良 TE 和 AGV 组的总成功率略高于 EX-PRESS 组。术后三组滤过泡形态差异无统计学意义。

结论

改良 TE、AGV 和 EX-PRESS 青光眼引流阀治疗 RG 的疗效相当，均可有效降低眼压和术后抗青光眼药物使用量。但末次随访时改良 TE 和 AGV 组的成功率略高于 EX-PRESS 组，并发症略少于 EX-PRESS 组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/b4c591ed9010/OMCL2022-3050007.009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/1e9a30b0d1c3/OMCL2022-3050007.001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/b4c591ed9010/OMCL2022-3050007.009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/1e9a30b0d1c3/OMCL2022-3050007.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/780060fff5aa/OMCL2022-3050007.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/0dae0e96d6fc/OMCL2022-3050007.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/5e7f75e01f17/OMCL2022-3050007.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/866950d3158d/OMCL2022-3050007.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/96f27ec6e37f/OMCL2022-3050007.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/ec64fceca496/OMCL2022-3050007.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/4cd4db154fc7/OMCL2022-3050007.008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d519/9150991/b4c591ed9010/OMCL2022-3050007.009.jpg

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Ex-PRESS implantation for different types of glaucoma.不同类型青光眼的Ex-PRESS植入术。
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