Zhang Wen-Jing, Qi Ying, Huang Xue-Tao, Yao Ren-Jie
Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Int J Ophthalmol. 2022 Oct 18;15(10):1604-1610. doi: 10.18240/ijo.2022.10.07. eCollection 2022.
To evaluate efficacy of microcatheter-assisted trabeculotomy (MAT) in eyes with secondary glaucoma after congenital cataract surgery and explore its correlation with the different degree of trabeculotomy.
A retrospective analysis was conducted on patients who underwent the said procedure between September 2019 and September 2020. The patients were classified into two groups according to the degree of trabeculotomy (group 1: ≤240-degree; group 2: 240-360-degree). The intraocular pressure (IOP) and anti-glaucoma drugs before and after operation was collected during the 12-month follow-up.
Totally 27 eyes of 25 patients were included: 11 (40.7%) eyes in group 1 and 16 (59.3%) eyes in group 2. The mean IOP of all patients was 34.67±9.18 mm Hg preoperatively and 8.74±4.32, 9.95±5.65, 14.39±5.30, 16.02±4.37, 15.82±3.28, and 16.19±3.56 mm Hg 1d, 1wk, 1, 3, 6, and 12mo after surgery, respectively. In all patients, there were significant differences in IOP at each time point (=65.614, <0.01). In each group, IOP after surgery was lower than that before surgery (all <0.01), but there was no difference in the rate of IOP reduction between the two groups (=0.246). Furthermore, the amount of anti-glaucoma medications reduced to 0.30±0.67 (0-2) at 12mo from 2.63±0.49 (2-3) preoperatively (<0.01), and there was no difference between the two groups (>0.05). At the end of follow-up, the partial success rate was 81.8% in group 1 93.75% in group 2 (=0.549). Various amount of intraoperative and postoperative hyphema occurred in all eyes, which spontaneously absorbed or cleaned through paracentesis and irrigation. No other serious complications was observed.
MAT can effectively reduce IOP in patients with secondary glaucoma after congenital cataract surgery with a high success rate and safety. And it can be used as the first choice for the treatment of secondary glaucoma after surgery for congenital cataracts.
评估微导管辅助小梁切开术（MAT）治疗先天性白内障术后继发性青光眼的疗效，并探讨其与不同小梁切开程度的相关性。
对2019年9月至2020年9月期间接受该手术的患者进行回顾性分析。根据小梁切开程度将患者分为两组（1组：≤240度；2组：240 - 360度）。在12个月的随访期间收集手术前后的眼压（IOP）及抗青光眼药物使用情况。
共纳入25例患者的27只眼，其中1组11只眼（40.7%），2组16只眼（59.3%）。所有患者术前平均眼压为34.67±9.18 mmHg，术后1天、1周、1个月、3个月、6个月和12个月时分别为8.74±4.32、9.95±5.65、14.39±5.30、16.02±4.37、15.82±3.28和16.19±3.56 mmHg。所有患者各时间点眼压差异有统计学意义（=65.614，<0.01）。每组患者术后眼压均低于术前（均<0.01），但两组眼压降低率差异无统计学意义（=0.246）。此外，抗青光眼药物用量从术前的2.63±0.49（2 - 3）降至术后12个月时的0.30±0.67（0 - 2）（<0.01），两组间差异无统计学意义（>0.05）。随访结束时，1组部分成功率为81.8%，2组为93.75%（=0.549）。所有眼均发生不同程度的术中及术后前房积血，均自行吸收或经前房穿刺冲洗清除。未观察到其他严重并发症。
MAT可有效降低先天性白内障术后继发性青光眼患者的眼压，成功率高且安全性好，可作为先天性白内障术后继发性青光眼治疗的首选方法。
