穿透性房角成形术治疗虹膜角膜内皮综合征继发青光眼实现房水内引流：一年结果
Achieving Inner Aqueous Drain in Glaucoma Secondary to Iridocorneal Endothelial Syndrome: One Year Results of Penetrating Canaloplasty.
作者信息
Deng Yuxuan, Zhang Shaodan, Ye Wenqing, Gu Juan, Lin Haishuang, Cheng Huanhuan, Xie Yanqian, Le Rongrong, Tao Yan, Zhang Wei, Chen Wei, Tham Clement C, He Mingguang, Wang Ningli, Liang Yuanbo
机构信息
From National Clinical Research Center for Ocular Diseases, The Eye Hospital of Wenzhou Medical University, Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China (Y.D, S.Z, W.Y, J.G, H.L, H.C, Y.X, R.L, Y.T, W.C, Y.L);; Qingdao Municipal Hospital, Qingdao, Shandong, China (Y.D);; Wuhu First People's Hospital, Wuhu, Anhui, China (H.C);; Biomedical Informatics and Statistics Center, School of Public Health, Fudan University, Shanghai, China (W.Z);; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China (C.C.T);; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (M.H);; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia (M.H);; Beijing Tongren Hospital, Beijing, China (N.W).
From National Clinical Research Center for Ocular Diseases, The Eye Hospital of Wenzhou Medical University, Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China (Y.D, S.Z, W.Y, J.G, H.L, H.C, Y.X, R.L, Y.T, W.C, Y.L);; Qingdao Municipal Hospital, Qingdao, Shandong, China (Y.D);; Wuhu First People's Hospital, Wuhu, Anhui, China (H.C);; Biomedical Informatics and Statistics Center, School of Public Health, Fudan University, Shanghai, China (W.Z);; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China (C.C.T);; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (M.H);; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia (M.H);; Beijing Tongren Hospital, Beijing, China (N.W).
出版信息
Am J Ophthalmol. 2022 Nov;243:83-90. doi: 10.1016/j.ajo.2022.07.006. Epub 2022 Jul 21.
PURPOSES
To report the efficacy of a bleb-independent penetrating canaloplasty in the management of glaucoma secondary to iridocorneal endothelial syndrome (GS-ICE).
DESIGN
Prospective, non-comparative clinical study.
METHODS
Penetrating canaloplasty was performed on 35 eyes from 35 patients with GS-ICE and medically uncontrolled intraocular pressure (IOP) between January 2018 and April 2020. Patients were followed up at 1 week, months 1, 3, 6, 12 postoperatively, and semi-annually thereafter. The IOP, anti-glaucoma medication, and surgery-related complications were recorded. Surgical success was defined as IOP ≥ 5 mmHg and ≤ 21 mmHg without (complete success) or with/without (qualified success) IOP-lowering medication.
RESULTS
A total of 29 eyes (82.9%) had 360° catheterization and successfully received penetrating canaloplasty. Of these eyes, 24 (82.8%) achieved qualified success and 22 (75.9%) achieved qualified success at 12 months after surgery. The mean IOP decreased from 39.5 ± 11.8 mmHg on 2.9 ± 1.0 medications before surgery to 16.6 ± 5.3 mmHg (P < .001) on 0.2 ± 0.6 medications (P < .001) at 12 months postoperatively, respectively. Hyphema (37.9%), transient hypotony (34.5%), and transient postoperative IOP elevation (≥ 30 mmHg, 17.9%) were the most commonly observed early complications at the 1 week and 1 month visits. From 1 month and beyond, all treated eyes showed no obvious bleb at the operation quadrant.
CONCLUSIONS
Penetrating canaloplasty rescued the inner aqueous outflow in ICE eyes and demonstrated acceptable success in IOP control with few complications, providing a new option for the management of GS-ICE.
目的
报告一种不依赖滤过泡的穿透性房角成形术治疗虹膜角膜内皮综合征（ICE综合征）继发青光眼的疗效。
设计
前瞻性、非对照临床研究。
方法
2018年1月至2020年4月，对35例ICE综合征且药物治疗不能控制眼压（IOP）的患者的35只眼进行穿透性房角成形术。术后1周、1、3、6、12个月及之后每半年对患者进行随访。记录眼压、抗青光眼药物使用情况及手术相关并发症。手术成功定义为眼压≥5 mmHg且≤21 mmHg，无需（完全成功）或使用/不使用（合格成功）降眼压药物。
结果
共有29只眼（82.9%）实现360°置管并成功接受穿透性房角成形术。其中，24只眼（82.8%）达到合格成功，22只眼（75.9%）在术后12个月达到合格成功。术前平均眼压为39.5±11.8 mmHg，使用2.9±1.0种药物，术后12个月分别降至16.6±5.3 mmHg（P <.001），使用0.2±0.6种药物（P <.001）。前房积血（37.9%）、短暂性低眼压（34.5%）和术后短暂性眼压升高（≥30 mmHg，17.9%）是术后1周和1个月最常见的早期并发症。术后1个月及以后，所有治疗眼手术象限均未出现明显滤过泡。
结论
穿透性房角成形术挽救了ICE综合征患眼的房水内引流，在眼压控制方面取得了可接受的成功率，并发症较少，为ICE综合征的治疗提供了新的选择。
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