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房角镜辅助经腔小梁切开术作为富克斯葡萄膜炎综合征青光眼的主要手术选择:病例系列

Gonioscopy-assisted transluminal trabeculotomy as a primary surgical option for glaucoma in Fuchs uveitis syndrome: A case series.

作者信息

Gunay Murat, Turk Adem, Kurt Ibrahim Mert, Uzlu Dilek, Kose Busra, Yildirim Yusuf

机构信息

Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Department of Ophthalmology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.

出版信息

Eur J Ophthalmol. 2024 Sep;34(5):NP16-NP21. doi: 10.1177/11206721241253304. Epub 2024 May 6.

DOI:10.1177/11206721241253304
PMID:38710201
Abstract

BACKGROUND

Fuchs uveitis syndrome (FUS) is a chronic intraocular inflammatory disease. It can lead to glaucoma which can be intractable to both medical and surgical treatment. In the present report, we describe our experience with GATT as a primary surgical option in the treatment of glaucoma secondary to FUS.

RESULTS

Four consecutive patients with FUS-associated glaucoma underwent GATT in a single institution. Case 1 was a 28-year-old pseudophakic male with a preoperative intraocular pressure (IOP) of 43 mmHg had unsuccessful circumferential cannulation; his IOP remained high after GATT and received trabeculectomy followed by Ahmed glaucoma valve (AGV) implantation to control IOP. Although IOP was stable following AGV, he required descemet membrane endothelial keratoplasty due to persistent corneal decompansation. He had a stable IOP of 12 mmHg over 21 months. Case 2 was a 42-year-old male with preoperative IOP of 35 mmHg and posterior subcapsular cataract had 360-degree GATT combined with phacoemulsification; his IOP reduced to 14 mmHg over 18 months. Case 3 was an 52-year-old pseudophakic male with a preoperative IOP of 28 mmHg had 360-degree GATT; his IOP remained stable at 10 mmHg over 18 months. Case 4 was an 47-year-old pseudophakic female with a preoperative IOP of 39 mmHg had 360-degree GATT; her IOP remained stable at 14 mmHg over 12 months.

CONCLUSION

GATT may be used as an initial approach in secondary glaucoma due to FUS. But, further evidence is still warranted to better ascertain the usefulness of GATT in this specific patient population.

摘要

背景

富克斯葡萄膜炎综合征(FUS)是一种慢性眼内炎症性疾病。它可导致青光眼,而青光眼的药物和手术治疗都可能难以奏效。在本报告中,我们描述了小梁消融术(GATT)作为原发性手术选择治疗FUS继发性青光眼的经验。

结果

连续4例FUS相关性青光眼患者在单一机构接受了GATT手术。病例1为一名28岁的人工晶状体植入男性,术前眼压(IOP)为43 mmHg,环形插管未成功;GATT术后眼压仍高,随后接受了小梁切除术,接着植入了艾哈迈德青光眼引流阀(AGV)以控制眼压。尽管AGV植入后眼压稳定,但由于角膜持续失代偿,他需要进行角膜内皮移植术。他在21个月内眼压稳定在12 mmHg。病例2为一名42岁男性,术前眼压为35 mmHg,合并后囊下白内障,接受了360度GATT联合超声乳化术;其眼压在18个月内降至14 mmHg。病例3为一名52岁的人工晶状体植入男性,术前眼压为28 mmHg,接受了360度GATT;其眼压在18个月内稳定在10 mmHg。病例4为一名47岁的人工晶状体植入女性,术前眼压为39 mmHg,接受了360度GATT;其眼压在12个月内稳定在14 mmHg。

结论

GATT可作为FUS继发性青光眼的初始治疗方法。但是,仍需要进一步的证据来更好地确定GATT在这一特定患者群体中的有效性。

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引用本文的文献

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Highlighting the limited efficacy of gonioscopy-assisted transluminal trabeculectomy in Fuchs uveitis syndrome: a case series.强调房角镜辅助经腔小梁切除术在富克斯葡萄膜炎综合征中的疗效有限:病例系列
BMC Ophthalmol. 2025 Apr 7;25(1):180. doi: 10.1186/s12886-025-04035-6.