Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama City, 930-0194, Japan.
Int Ophthalmol. 2024 Jul 23;44(1):333. doi: 10.1007/s10792-024-03248-w.
We compared corneal endothelial cell (CED) loss after Ex-Press (EXP) surgery between patients with primary open-angle glaucoma (POAG) and pseudo-exfoliation glaucoma (PEX).
This was a single-facility retrospective study. We included glaucoma patients who had undergone EXP surgery and were followed up > 3 years. We measured the CED before and after (at 12, 24, and 36 months) EXP surgery by noncontact specular microscopy and compared the means of the CED values and CED survival ratios after EXP surgery by paired t-test.
We included 119 eyes that underwent EXP surgery, including 60 POAG eyes and 59 PEX eyes. In the POAG group, the mean CED decreased from 2389 ± 321 at baseline to 2230 ± 424 cells/mm after 3 years. In the PEX group, the mean CED decreased from 2111 ± 510 at baseline to 1845 ± 628 cells/mm after 3 years. At the 3-year follow-up, the CED survival ratio was 93.3 ± 12.5% in the POAG group and significantly lower, at 85.0 ± 19.5%, in the PEX group (p = 0.0064). Two cases in the PEX group developed bullous keratopathy.
EXP surgery decreased the corneal endothelial cell populations in PEX patients faster than POAG patients.
我们比较了原发性开角型青光眼（POAG）和假性剥脱性青光眼（PEX）患者 Ex-Press（EXP）手术后角膜内皮细胞（CED）的丢失情况。
这是一项单中心回顾性研究。我们纳入了接受 EXP 手术且随访时间超过 3 年的青光眼患者。通过非接触式共焦显微镜测量 EXP 手术前后的 CED，并通过配对 t 检验比较 EXP 手术后 CED 值的平均值和 CED 存活率。
我们纳入了 119 只接受 EXP 手术的眼睛，包括 60 只 POAG 眼和 59 只 PEX 眼。在 POAG 组中，CED 平均值从基线时的 2389±321 个细胞/mm2降至 3 年后的 2230±424 个细胞/mm2。在 PEX 组中，CED 平均值从基线时的 2111±510 个细胞/mm2降至 3 年后的 1845±628 个细胞/mm2。在 3 年随访时，POAG 组的 CED 存活率为 93.3±12.5%，显著低于 PEX 组的 85.0±19.5%（p=0.0064）。PEX 组中有 2 例发生大泡性角膜病变。
EXP 手术使 PEX 患者的角膜内皮细胞数量比 POAG 患者更快地减少。
