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连续36例葡萄膜炎性青光眼患者行内路小梁切开术的疗效

Outcomes of Microhook ab Interno Trabeculotomy in Consecutive 36 Eyes with Uveitic Glaucoma.

作者信息

Sotani Noriyuki, Kusuhara Sentaro, Matsumiya Wataru, Okuda Mina, Mori Sotaro, Sotani Rei, Kim Kyung Woo, Nishisho Ryuto, Nakamura Makoto

机构信息

Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.

出版信息

J Clin Med. 2022 Jun 29;11(13):3768. doi: 10.3390/jcm11133768.

DOI:10.3390/jcm11133768
PMID:35807053
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9267751/
Abstract

Microhook trabeculotomy (μLOT), recently developed by Tanito belongs to minimally invasive glaucoma surgery and contributes to intraocular pressure (IOP) control in eyes with glaucoma resistant to medical therapy. In this study, we aimed to investigate the effectiveness and safety of μLOT for uveitic glaucoma. The medical records of consecutive 36 eyes from 30 patients who underwent μLOT and were followed up over post-operative 1 year were reviewed. The surgical success (IOP = 5-20 mmHg and ΔIOP ≥ 20% with additional anti-glaucoma drugs) was achieved in 67% of eyes at post-operative 12 months. The median IOP significantly decreased from 30.5 mmHg pre-operatively to 15 mmHg at 12 months post-operatively ( = 0.001), and the median glaucoma drug score changed from 5 pre-operatively to 2.5 at 12 months post-operatively ( = 0.301). Intraocular inflammation scores at post-operative 6 weeks did not show a significant worsening as compared to pre-operatively, and 8 (22%) eyes exhibited exacerbation of inflammation during the 12-month follow-up period. Post-operative complications were confirmed in 58% of eyes, but most of them were mild and transient or successfully managed. With its favorable benefit-risk profile, μLOT would be an option worth considering as the first glaucoma surgery for uveitic glaucoma.

摘要

微钩小梁切开术(μLOT)是谷仁堂最近研发的一种微创青光眼手术,有助于控制药物治疗无效的青光眼患者的眼压。在本研究中,我们旨在探讨μLOT治疗葡萄膜炎性青光眼的有效性和安全性。回顾了连续30例接受μLOT手术并随访1年以上的患者的36只眼的病历。术后12个月时,67%的患眼获得手术成功(眼压=5-20 mmHg,使用额外抗青光眼药物时眼压下降≥20%)。眼压中位数从术前的30.5 mmHg显著降至术后12个月时的15 mmHg(P = 0.001),青光眼药物评分中位数从术前的5分变为术后12个月时的2.5分(P = 0.301)。术后6周时的眼内炎症评分与术前相比未显示明显恶化,8只眼(22%)在12个月的随访期内出现炎症加重。58%的患眼确认有术后并发症,但大多数并发症较轻且为一过性或得到成功处理。鉴于其良好的效益风险比,μLOT可作为葡萄膜炎性青光眼首次青光眼手术值得考虑的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7db/9267751/0ec3f541d552/jcm-11-03768-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7db/9267751/a0cb31e23263/jcm-11-03768-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7db/9267751/9754f6ee147f/jcm-11-03768-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7db/9267751/f499bd13bf61/jcm-11-03768-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7db/9267751/0ec3f541d552/jcm-11-03768-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7db/9267751/a0cb31e23263/jcm-11-03768-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7db/9267751/9754f6ee147f/jcm-11-03768-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7db/9267751/f499bd13bf61/jcm-11-03768-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7db/9267751/0ec3f541d552/jcm-11-03768-g004.jpg

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本文引用的文献

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Acta Ophthalmol. 2022 Sep;100(6):e1209-e1215. doi: 10.1111/aos.15090. Epub 2022 Jan 26.
2
Noninferiority of Microhook to Trabectome: Trabectome versus Ab Interno Microhook Trabeculotomy Comparative Study (Tram Trac Study).微钩与小梁切开术的非劣效性比较:小梁切开术与内路微钩小梁切开术的比较研究(Tram Trac 研究)。
Ophthalmol Glaucoma. 2022 Jul-Aug;5(4):452-461. doi: 10.1016/j.ogla.2021.11.005. Epub 2021 Nov 25.
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Outcomes of Primary 27-Gauge Vitrectomy for 73 Consecutive Cases With Uveitis-Associated Vitreoretinal Disorders.
J Clin Med. 2024 Feb 20;13(5):1185. doi: 10.3390/jcm13051185.
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Favorable effect of ripasudil use on surgical outcomes of microhook ab interno trabeculotomy.利匹司特滴眼剂对微切口内路小梁切开术手术效果的有益影响。
Graefes Arch Clin Exp Ophthalmol. 2023 Sep;261(9):2603-2610. doi: 10.1007/s00417-023-06040-1. Epub 2023 Mar 31.
连续73例葡萄膜炎相关性玻璃体视网膜疾病患者接受27G原发性玻璃体切除术的结果
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