Maheshwari Devendra, Goyal Rinkal, Pillai Madhavi Ramanatha, Gupta Shivam, Chautani Drishti, Ramakrishnan Rengappa
Department of Glaucoma Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
Indian J Ophthalmol. 2025 Mar 1;73(Suppl 2):S214-S219. doi: 10.4103/IJO.IJO_1257_24. Epub 2024 Dec 27.
To assess the safety and efficacy of non-penetrating deep sclerectomy (NPDS) in advanced open-angle glaucoma patients.
Retrospective observational study.
Forty-two eyes of 38 patients with advanced glaucoma who underwent NPDS surgery combined with mitomycin-C with or without phacoemulsification were evaluated for up to 12 months at a tertiary eye care center in South India. Patients with intraoperative perforation of the trabeculo-Descemet membrane who did not meet the follow-up criteria were excluded. The primary outcome measured was intraocular pressure (IOP) reduction postoperatively on day 1, week 2, and months 1, 3, 6, and 12. The secondary outcomes measured were the need for antiglaucoma medications (AGMs), postoperative complications, and interventions.
Patients enrolled had a mean age of 61.08 ± 10.2 years. There was a statistically significant reduction ( P < 0.001) of IOP from 29.48 ± 10.89 mmHg (baseline) to 11.58 ± 6.29, 11.90 ± 5.99, 13.60 ± 7.06, 14.03 ± 8.00, 13.94 ± 4.65, and 13.19 ± 3.29 mmHg at day 1, week 2, and months 1, 3, 6, and 12, respectively. The number of AGMs reduced from 3.14 ± 1.03 preoperatively to 1.85 ± 0.83 at 12 months postoperatively ( P < 0.001). Nd: YAG laser goniopuncture was done in 21.4%, bleb needling in 11.9%, and one patient underwent 260° trabeculotomy after NPDS. There were no cases of choroidal detachment or wipeout.
NPDS with or without phacoemulsification has good safety for managing advanced open-angle glaucoma.
评估非穿透性深层巩膜切除术（NPDS）在晚期开角型青光眼患者中的安全性和有效性。
回顾性观察研究。
在印度南部的一家三级眼科护理中心，对38例接受NPDS手术联合丝裂霉素C（有或无超声乳化术）的晚期青光眼患者的42只眼睛进行了长达12个月的评估。术中小梁-Descemet膜穿孔且不符合随访标准的患者被排除。测量的主要结局是术后第1天、第2周以及第1、3、6和12个月时眼压（IOP）的降低情况。测量的次要结局是抗青光眼药物（AGM）的使用需求、术后并发症和干预措施。
入组患者的平均年龄为61.08±10.2岁。眼压从29.48±10.89 mmHg（基线）分别显著降低（P<0.001）至术后第1天的11.58±6.29 mmHg、第2周的11.90±5.99 mmHg、第1个月的13.60±7.06 mmHg、第3个月的14.03±8.00 mmHg、第6个月的13.94±4.65 mmHg和第12个月的13.19±3.29 mmHg。AGM的使用数量从术前的3.14±1.03减少至术后12个月时的1.85±0.83（P<0.001）。21.4%的患者进行了钕：钇铝石榴石激光房角穿刺，11.9%的患者进行了滤过泡针刺，1例患者在NPDS术后接受了260°小梁切开术。没有脉络膜脱离或滤过泡消失的病例。
NPDS联合或不联合超声乳化术在治疗晚期开角型青光眼方面具有良好的安全性。
