Esnoper 夹植入物行深层巩膜切除术治疗未控制的原发性开角型青光眼的疗效和安全性：一项为期 1 年的前瞻性研究。

Efficacy and Safety of Deep Sclerectomy With the Esnoper Clip Implant for Uncontrolled Primary Open Angle Glaucoma: A 1 Year Prospective Study.

机构信息

Department of Ophthalmology, University Hospital Královské Vinohrady.

Department of Medical Biophysics and Informatics, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.

出版信息

J Glaucoma. 2023 Mar 1;32(3):227-235. doi: 10.1097/IJG.0000000000002137. Epub 2022 Oct 14.

DOI:10.1097/IJG.0000000000002137

PMID:36256952

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9981320/

Abstract

PRCIS

Deep sclerectomy (DS) with the Esnoper Clip drainage implant in patients with uncontrolled primary open angle glaucoma (POAG) achieved a complete success rate of 87.2% at the 1-year follow-up.

PURPOSE

To investigate the efficacy and safety of DS followed by Esnoper Clip implantation in patients with uncontrolled POAG.

MATERIALS AND METHODS

In a prospective, consecutive, interventional study, we investigated 39 eyes of 35 patients with uncontrolled POAG who underwent DS with Esnoper Clip implantation. Complete ophthalmologic examinations including corrected visual acuity and intraocular pressure (IOP), were performed preoperatively, and at 1 day, at 1 week as well as at 1, 3, 6, 9, and 12 months postoperatively. Moreover, any goniopunctures and glaucoma medications required postoperatively were noted.

RESULTS

The mean preoperative IOP was 20.8±5.2 mm Hg and it decreased to 13.9±3.1 mm Hg at 1 year postoperatively ( P <0.001). The number of glaucoma medications decreased from 2.9±0.7 preoperatively to 0.3±0.8 after 1 year ( P <0.001). The complete success rate (IOP≤21 mm Hg without glaucoma medication) and the qualified success rate (IOP ≤21 mm Hg with or without glaucoma medication) were 87.2% and 94.9%, respectively. Goniopuncture was performed in 33.3% of cases. No significant corrected visual acuity changes were registered at the final follow-up. Perioperative complications consisted of 3 micro-perforations of the trabeculo-descemet membrane. Postoperative complications included: hyphema (6 eyes), hypotony (6 eyes), shallow anterior chamber (3 eyes), choroidal detachment (4 eyes)-all of which were resolved without surgical intervention during the first postoperative month-and conjunctival dehiscence, which required resuture (2 eyes).

CONCLUSION

Deep sclerectomy with the Esnoper Clip implant was safe and effectively lowered IOP in patients with uncontrolled POAG.

摘要

PRCIS

在未控制的原发性开角型青光眼（POAG）患者中，行深层巩膜切除术（DS）联合 Esnoper 夹引流植入物治疗，1 年随访时完全成功率为 87.2%。

目的

研究 DS 联合 Esnoper 夹植入物治疗未控制的 POAG 患者的疗效和安全性。

材料和方法

前瞻性、连续、干预性研究，共纳入 35 例 39 眼未控制的 POAG 患者，行 DS 联合 Esnoper 夹植入物治疗。所有患者均行完整的眼科检查，包括矫正视力和眼压（IOP），分别于术前、术后 1 天、1 周以及 1、3、6、9 和 12 个月进行。此外，还记录了术后任何房角穿刺和青光眼药物的使用情况。

结果

术前平均 IOP 为 20.8±5.2mmHg，术后 1 年降至 13.9±3.1mmHg（P＜0.001）。术前青光眼药物使用数量为 2.9±0.7 种，术后 1 年降至 0.3±0.8 种（P＜0.001）。完全成功率（IOP≤21mmHg，无需青光眼药物治疗）和合格成功率（IOP≤21mmHg，无论是否使用青光眼药物）分别为 87.2%和 94.9%。33.3%的病例进行了房角穿刺。最终随访时，矫正视力无明显变化。围手术期并发症包括 3 例小梁-内皮层穿孔。术后并发症包括：前房积血（6 眼）、低眼压（6 眼）、浅前房（3 眼）、脉络膜脱离（4 眼）-所有这些并发症在术后 1 个月内无需手术干预即可解决-和结膜裂开，需要重新缝合（2 眼）。