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小儿先天性白内障手术后植入保罗青光眼植入物。

Paul Glaucoma Implant following Congenital Cataract Surgery in a Pediatric Cohort.

作者信息

Mendoza-Moreira Angi Lizbeth, Voigt Anna Maria, Stingl Julia V, Rezapour Jasmin, Wagner Felix Mathias, Schuster Alexander K, Hoffmann Esther M

机构信息

Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany.

出版信息

J Clin Med. 2024 May 15;13(10):2914. doi: 10.3390/jcm13102914.

Abstract

: The aim of this study was to evaluate the short-term efficacy and safety of the Paul Glaucoma Implant (PGI) in pediatric eyes diagnosed with glaucoma following congenital cataract surgery (GFCS). : A retrospective, single-center, descriptive study was conducted on consecutive children diagnosed with GFCS who underwent PGI implantation between July 2022 and November 2023 at the University Medical Center Mainz. The primary outcome measure was the reduction in IOP at the last follow-up visit. : Ten eyes of nine children were included in the study. The mean follow-up time was 7.70 ± 4.22 months (4.68-10.72 months). At the end of the study follow-up, the mean (95% CI) reduction in IOP was -14.8 ± 8.73 mmHg (-8.56 to -21.04 mmHg, < 0.001). At the last follow-up, 30.0% (3/10) of patients achieved an IOP (intraocular pressure) of ≥6 and ≤21 mmHg with a reduction in IOP of ≥25% without treatment, while 90.0% (9/10) achieved this target IOP regardless of glaucoma medication treatment. The mean number of antiglaucoma medications was significantly reduced from 3.50 (IQR = 1) to 2.0 (IQR = 2, = 0.01), and the visual acuity logMAR improved from 1.26 ± 0.62 to 1.03 ± 0.48 ( = 0.04). Only one eye experienced numerical hypotony (4 mmHg) without choroidal detachment or anterior chamber shallowing within the first 24 h. No other adverse events were observed during the follow-up period. : PGI implantation significantly lowered IOP and the number of antiglaucoma eye drops with a favorable safety profile in children diagnosed with GFCS, thereby achieving a high rate of qualified surgical success in the short term.

摘要

本研究的目的是评估保罗青光眼植入物(PGI)在先天性白内障手术后被诊断为青光眼的儿童眼中的短期疗效和安全性。:对2022年7月至2023年11月在美因茨大学医学中心接受PGI植入的连续诊断为先天性白内障手术后青光眼的儿童进行了一项回顾性、单中心、描述性研究。主要结局指标是最后一次随访时眼压的降低。:九名儿童的十只眼睛被纳入研究。平均随访时间为7.70±4.22个月(4.68 - 10.72个月)。在研究随访结束时,眼压的平均(95%CI)降低为-14.8±8.73 mmHg(-8.56至-21.04 mmHg,<0.001)。在最后一次随访时,30.0%(3/10)的患者在未治疗的情况下眼压降低≥25%,眼压达到≥6且≤21 mmHg,而90.0%(9/10)的患者无论是否使用青光眼药物治疗均达到该目标眼压。抗青光眼药物的平均数量从3.50(IQR = 1)显著减少至2.0(IQR = 2,P = 0.01),视力logMAR从1.26±0.62提高至1.03±0.48(P = 0.04)。只有一只眼睛在最初24小时内出现数值性低眼压(4 mmHg),无脉络膜脱离或前房变浅。随访期间未观察到其他不良事件。:PGI植入显著降低了先天性白内障手术后青光眼儿童的眼压和抗青光眼眼药水的使用数量,安全性良好,从而在短期内实现了较高的合格手术成功率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/531d/11122222/2a954406fd1b/jcm-13-02914-g001.jpg

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本文引用的文献

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Br J Ophthalmol. 2023 Dec 21;107(Suppl 1):1-114. doi: 10.1136/bjophthalmol-2023-egsguidelines.
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Adv Ophthalmol Pract Res. 2023 Sep 23;3(4):171-179. doi: 10.1016/j.aopr.2023.09.001. eCollection 2023 Nov-Dec.
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Ophthalmol Glaucoma. 2024 Mar-Apr;7(2):131-138. doi: 10.1016/j.ogla.2023.08.009. Epub 2023 Sep 6.
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Clinical outcomes of the PAUL® glaucoma implant: One-year results.
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The PAUL® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort.
Graefes Arch Clin Exp Ophthalmol. 2023 Aug;261(8):2351-2358. doi: 10.1007/s00417-023-06000-9. Epub 2023 Mar 21.
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