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原发性先天性青光眼双位点与单位点刚性探头粘小管切开术的一年结果

One-year results of double site versus single site rigid probe viscotrabeculotomy in primary congenital glaucoma.

作者信息

El Hefney Eman M, Atallah Eman A, Kishk Hanem, Elwehidy Ahmed S, Abd Elfattah Dina

机构信息

Ophthalmology, Faculty of Medicine, Mansoura University, Egypt.

出版信息

Eur J Ophthalmol. 2025 Jul;35(4):1295-1304. doi: 10.1177/11206721241310269. Epub 2025 Jan 29.

DOI:10.1177/11206721241310269
PMID:39876771
Abstract

Study purposeto compare single- site viscotrabeculotomy in one eye and double-site rigid probe viscotrabeculotomy in the other eye of the same patient with Primary congenital glaucoma to evaluate the effect of the extent of angle treatment on success rate in the study's locality.Patients and MethodsThis prospective randomized study included 70 eyes of 35 children diagnosed with bilateral PCG who attended Mansoura Ophthalmic Center from June 2021 to July 2023. For each patient, one eye underwent single-site rigid probe viscotrabeculotomy (Group S: 35 eyes) and the fellow eye underwent double- site rigid probe viscotrabeculotomy (Group D: 35 eyes). At one-year follow up, complete success was defined as IOP >5 mmHg and ≤16 mmHg without any further IOP-lowering medications and qualified success when IOP ≤16 mmHg with using IOP-lowering medications. Failure was defined as IOP more than 16 mmHg despite the use of IOP-lowering medications, the need for other glaucoma surgery to control IOP or hypotony.ResultsSingle-site rigid probe viscotrabeculotomy showed a one-year complete success rate of 88.57% and for double-site viscotrabeculotomy was 91.43% but the difference was not statistically significant (p-value 0.9). There were no major complications in both groups, hyphema was the most common complication and was self-limitedConclusionSingle-site viscotrabeculotomy shows comparable results to double-site viscotrabeculotomy in PCG preserving more than half of the angle in the former for a second possible angle surgery in recurrent cases.

摘要

研究目的

比较同一原发性先天性青光眼患者一只眼行单部位粘小管切开术,另一只眼行双部位硬性探头粘小管切开术,以评估在本研究地区房角治疗范围对成功率的影响。

患者与方法

这项前瞻性随机研究纳入了2021年6月至2023年7月在曼苏拉眼科中心就诊的35例双侧原发性先天性青光眼患儿的70只眼。对于每位患者,一只眼行单部位硬性探头粘小管切开术(S组:35只眼),对侧眼行双部位硬性探头粘小管切开术(D组:35只眼)。在一年的随访中,完全成功定义为眼压>5 mmHg且≤16 mmHg,无需任何进一步的降眼压药物;使用降眼压药物时眼压≤16 mmHg为合格成功。失败定义为尽管使用了降眼压药物眼压仍高于16 mmHg、需要其他青光眼手术来控制眼压或出现低眼压。

结果

单部位硬性探头粘小管切开术的一年完全成功率为88.57%,双部位粘小管切开术为91.43%,但差异无统计学意义(p值0.9)。两组均无严重并发症,前房积血是最常见的并发症且为自限性。

结论

在原发性先天性青光眼中,单部位粘小管切开术与双部位粘小管切开术效果相当,前者在复发病例中保留了超过一半的房角,为二次可能的房角手术创造了条件。

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