Sanchez E, Schnyder C C, Sickenberg M, Chiou A G, Hédiguer S E, Mermoud A
Hôpital Ophtalmique Jules Gonin, Department of Ophthalmology, University of Lausanne, Switzerland.
Int Ophthalmol. 1996;20(1-3):157-62. doi: 10.1007/BF00212963.
To study the need, the safety and the success rate of collagen implant in eyes that underwent deep sclerectomy, a new non penetrating filtration procedure, we compared the results of deep sclerectomy with (DSCI) and without (DS) collagen implant.
Of 168 patients (168 eyes) with various types of medically uncontrolled open angle glaucoma, 86 (86 eyes) underwent DSCI, and 82 (82 eyes) underwent DS. Visual acuity, slit lamp examination, intraocular pressure (IOP) measurements were performed before surgery and prospectively at days 1 and 7 and months, 1, 2, 3, 6, 9, 12, 15, 18, and 24 after surgery. Deep sclerectomy was performed according to Kozlov's original technique. The collagen implant drainage device was radially secured in the center of the deep sclerectomy dissection.
The mean follow-up period was 9.7 +/- 6.5 months for DSCI, and 9.0 +/- 4.8 months for DS. The mean preoperative IOP was 26.9 +/- 8.8 mmHg for DSCI and 25.8 +/- 8.5 mmHg for DS. The mean postoperative IOP and visual acuity were similar between the two groups. Complete and qualified success rates were better when the collagen implant was used (Log-Rank test: p = 0.0002 and 0.033 for complete and qualified success respectively). The need for postoperative glaucoma medications was significantly lower when the collagen implant was used (0.2 +/- 0.5 versus 0.5 +/- 0.7 medication per patient in the DSCI and DS respectively, Student's t test: p = 0.0038). There was significantly less bleb fibrosis when the collagen implant was used (2% and 11% in DSCI and DS respectively, p = 0.029).
The collagen implant device is safe, increases the success rate of deep sclerectomy, and lowers the need for postoperative glaucoma medications.
为研究在接受深层巩膜切除术（一种新型非穿透性滤过手术）的眼中使用胶原植入物的必要性、安全性和成功率，我们比较了使用（DSCI）和未使用（DS）胶原植入物的深层巩膜切除术的结果。
在168例（168眼）各种类型药物治疗无法控制的开角型青光眼患者中，86例（86眼）接受了DSCI，82例（82眼）接受了DS。术前以及术后第1天、第7天、1个月、2个月、3个月、6个月、9个月、12个月、15个月、18个月和24个月前瞻性地进行视力、裂隙灯检查、眼压（IOP）测量。深层巩膜切除术按照科兹洛夫的原始技术进行。胶原植入物引流装置径向固定在深层巩膜切除术剥离区的中心。
DSCI组的平均随访期为9.7±6.5个月，DS组为9.0±4.8个月。DSCI组术前平均眼压为26.9±8.8 mmHg，DS组为25.8±8.5 mmHg。两组术后平均眼压和视力相似。使用胶原植入物时完全成功率和合格成功率更高（对数秩检验：完全成功和合格成功的p值分别为0.0002和0.033）。使用胶原植入物时术后青光眼药物的使用需求显著更低（DSCI组和DS组每位患者分别为0.2±0.5和0.5±0.7种药物，学生t检验：p = 0.0038）。使用胶原植入物时滤过泡纤维化明显更少（DSCI组和DS组分别为2%和11%，p = 0.029）。
胶原植入物装置安全，提高了深层巩膜切除术的成功率，并降低了术后青光眼药物的使用需求。
