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使用易于移除的不可吸收双缝线进行内管阻塞:一种用于无瓣膜青光眼引流装置的新型手术技术辅助方法

Internal Tube Occlusion with An Easily Removable Non-Absorbable Double Suture: A Novel Surgical Technique Adjunct for Non-Valved Glaucoma Drainage Devices.

作者信息

Savastano Alfonso, Gambini Gloria, Savastano Maria Cristina, Carlà Matteo Mario, Rizzo Clara, Caporossi Tomaso, Crincoli Emanuele, Rizzo Stanislao

机构信息

Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.

Ophthalmology Unit, Catholic University "Sacro Cuore", 00168 Rome, Italy.

出版信息

Vision (Basel). 2023 Feb 24;7(1):14. doi: 10.3390/vision7010014.

Abstract

To describe a surgical variant for non-valved glaucoma drainage device implants using an easily removable non-absorbable double suture into the lumen of the tube. A retrospective, non-comparative case series of 10 patients who underwent a non-valved glaucoma drainage device implant with an endoluminal double-suture for refractory glaucoma. The sutures were easily removed postoperatively without the need for an operating room. Intraocular pressure, number of medications, and early and late complications were evaluated with a follow-up of 12 months. None of the eyes that underwent an operation developed early or late complications. The first endoluminal suture was removed in all eyes with a mean time of removal of 30 ± 7 days. The second suture was removed in all eyes with a mean time of removal of 90 ± 7 days. No complications were noted, either, after or during suture removal. The mean preoperative IOP was 27.3 ± 4.0 and the postoperative IOP, at the end of the follow-up, was 12.7 ± 1.4. At the end of the follow-up, six patients (60%) achieved complete success and four patients (40%) achieved qualified success. In conclusion, in our case series, the surgical variant allowed for a safe and gradual regulation of the flow during postoperative management. Considering the efficacy of non-valved glaucoma drainage devices, an improvement in the safety profile allows surgeons to broaden the surgical indications.

摘要

描述一种用于非瓣膜性青光眼引流装置植入的手术变体,该变体使用一种易于移除的不可吸收双缝线置于引流管腔内。对10例难治性青光眼患者进行非瓣膜性青光眼引流装置植入并采用管腔内双缝线技术的回顾性、非对照病例系列研究。术后缝线易于移除,无需进入手术室。随访12个月,评估眼压、用药数量以及早期和晚期并发症。所有接受手术的眼睛均未出现早期或晚期并发症。所有眼睛均移除了第一根管腔内缝线,平均移除时间为30±7天。所有眼睛均移除了第二根缝线,平均移除时间为90±7天。移除缝线期间及之后均未发现并发症。术前平均眼压为27.3±4.0,随访结束时术后眼压为12.7±1.4。随访结束时,6例患者(60%)取得完全成功,4例患者(40%)取得合格成功。总之,在我们的病例系列中,这种手术变体在术后管理期间能够安全、逐步地调节引流。考虑到非瓣膜性青光眼引流装置的疗效,安全性的提高使外科医生能够扩大手术适应症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/198b/10057999/8a3611fecff4/vision-07-00014-g001.jpg

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