Le Rongrong, Xie Yanqian, Cheng Huanhuan, Chen Hong, Ye Wenqing, Deng Yuxuan, Gu Juan, Xu Jing, Hu Cheng, Zhang Shaodan, Liang Yuanbo
The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University.
National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang.
J Glaucoma. 2023 Jan 1;32(1):34-39. doi: 10.1097/IJG.0000000000002111. Epub 2022 Aug 19.
Penetrating canaloplasty was safe and effective for the management of refractory childhood glaucoma.
The purpose of this paper is to report the safety and efficacy of penetrating canaloplasty for the management of childhood glaucoma.
This single-center prospective interventional case series enrolled 50 eyes of 32 patients with childhood glaucoma between July 2017 and July 2020. Penetrating canaloplasty to create direct communication between the anterior chamber and tensioning suture-dilated the Schlemm canal was performed through a trabecular meshwork ostium in the affected eyes. Preoperative and postoperative intraocular pressure (IOP), number of glaucoma medications, and procedure-related complications were recorded. Qualified and complete success was defined as IOP≥5 and ≤21 mm Hg with or without glaucoma medications, respectively.
A total of 43 eyes (86.0%) achieved 360 degrees catheterization of Schlemm canal and completed penetrating canaloplasty. The median age at surgery was 5 years (range, 10 d-17 y, mean 6.20±5.46 y). The mean IOP decreased from 33.11±10.89 mm Hg on 2 medications (median, range: 0-5) before surgery to 13.46±4.71 mm Hg on 0 medications (median, range:0-2) postoperatively at 12 months ( P <0.001). Complete and qualified success rates were 81.08% and 89.19%, respectively, at the 12-month follow-up. Hyphema (6/43, 13.95%) and a transient shallow anterior chamber with hypotony (5/43, 11.63%) were the most commonly observed early complications.
Penetrating canaloplasty demonstrated good safety and efficacy in eyes with childhood glaucoma, and may be considered an option for managing refractory childhood glaucoma.
穿透性小梁切开术治疗儿童难治性青光眼安全有效。
本文旨在报告穿透性小梁切开术治疗儿童青光眼的安全性和有效性。
本单中心前瞻性干预性病例系列研究纳入了2017年7月至2020年7月期间32例儿童青光眼患者的50只眼。通过患眼小梁网开口进行穿透性小梁切开术，以建立前房与拉紧缝线扩张的施莱姆管之间的直接沟通。记录术前和术后的眼压（IOP）、青光眼药物使用数量以及与手术相关的并发症。合格成功和完全成功分别定义为使用或不使用青光眼药物时眼压≥5且≤21 mmHg。
共有43只眼（86.0%）实现了施莱姆管360度置管并完成穿透性小梁切开术。手术时的中位年龄为5岁（范围：10天至17岁，平均6.20±5.46岁）。平均眼压从术前使用2种药物（中位数，范围：0 - 5）时的33.11±10.89 mmHg降至术后12个月不使用药物（中位数，范围：0 - 2）时的13.46±4.71 mmHg（P <0.001）。在12个月的随访中，完全成功率和合格成功率分别为81.08%和89.19%。前房积血（6/43，13.95%）和短暂性浅前房伴低眼压（5/43，11.63%）是最常见的早期并发症。
穿透性小梁切开术在儿童青光眼眼中显示出良好的安全性和有效性，可被视为治疗儿童难治性青光眼的一种选择。
