Ex-PRESS引流钉植入术与小梁切除术治疗开角型青光眼的早期疗效比较  

Comparison of therapeutic effect in early stage between Ex-PRESS implantation and trabeculectomy for open angle glaucoma

作　　者：韩光杰[1] 周和政[1] 张文强[1] 黄志坚[1] 闫明[1] 

机构地区：[1]南方医科大学附属武汉临床学院广州军区武汉总医院全军眼科中心,湖北省武汉市430070

出　　处：《眼科新进展》2014年第8期758-760,共3页Recent Advances in Ophthalmology

摘　　要：目的对比观察Ex-PRESS引流钉植入术与小梁切除术治疗开角型青光眼(open angle glaucoma,OAG)的早期疗效与安全性。方法回顾性分析在我院同一时期接受Ex-PRESS引流钉(P50)植入术(29例33眼,Ex-PRESS组)与小梁切除术(28例36眼,小梁组)患者的临床资料,统计两组患者的病种构成、理论住院天数、并发症发生率、出入院时的视力和眼压变化情况,统计分析两种手术治疗OAG的短期疗效与安全性。结果 Ex-PRESS组和小梁组患眼中男女比例分别为1.75∶1、1.77∶1(P>0.05);年龄分别为(39±3)岁、(41±3)岁(P>0.05)。Ex-PRESS组中单纯的原发性开角型青光眼(primary open angle glaucoma,POAG)患者较少(P<0.05)。Ex-PRESS组和小梁组病例的理论住院时间分别为(3.12±0.33)d、(4.47±1.67)d (P<0.05),Ex-PRESS组的理论住院时间较短。Ex-PRESS组和小梁组的并发症发生率分别为0、8.33%(P<0.05),Ex-PRESS组的并发症较少。Ex-PRESS组和小梁组患者手术前后视力变化平均值分别为0.009、0.096(P<0.05),Ex-PRESS组术后视力下降较少。Ex-PRESS组和小梁组患者手术前后眼压下降值分别为(22.05±13.20)mmHg(1 kPa=7.5 mmHg)、(21.11±13.58)mmHg,两组手术前后眼压差异无统计学意义(P>0.05)。结论Ex-PRESS引流钉植入术不仅能够达到小梁切除术相同的早期治疗效果,而且具有术后视力下降及并发症较少、术后恢复快、住院时间短等优点,除适用于单纯POAG外,尤其适用于各种继发性OAG和伴有危险因素POAG患者。Objective To compare the therapeutic effect and safety in early stage between ExPRESS implantation and trabeculectomy for open angle glaucoma（ OAG）. Methods The clinical data of 57 cases with OAG treated with Ex-PRESS（ P50） implantation（ 29 cases, 33 eyes） or trabeculectomy（ 28 cases, 36 eyes） in our hospital during the same period were retrospectively analyzed,and the disease composition,theoretical days of hospitalization, incidences of complications and changes in visual acuity and intraocular pressure（ IOP） between admission and discharge were statistically evaluated. Results The rate of males and females in Ex-PRESS group and trabeculectomy group are 1. 75： 1 and 1. 77： 1（ P ＆gt; 0. 05）,the age were（ 39 ± 3） years old and（ 41 ± 3）years old（ P ＆gt; 0. 05）. The disease composition of the two groups was significantly different（ P ＆lt;0. 05） with less pure primary open angle glaucoma（ POAG） cases in Ex-PRESS group. Theoretical days of hospitalization of Ex-PRESS group and trabeculectomy group were（ 3. 12 ± 0. 33）days and（ 4. 47 ± 1. 67） days（ P ＆lt; 0. 05）. The incidences of complications of Ex-PRESS group and trabeculectomy group were 0 and 8. 33%（ P ＆lt; 0. 05）. The changed value of visual acuity of Ex-PRESS group and trabeculectomy group were 0. 009 and 0. 096（ P ＆lt; 0. 05. The decreased value of IOP of Ex-PRESS group and trabeculectomy group were（ 22. 05 ± 13. 20） mmHg（ 1kPa = 7. 5 mmHg） and（ 21. 11 ± 13. 58） mmHg（ P ＆gt; 0. 05）. Conclusion Although trabeculectomy and Ex-PRESS implantation provide a similar IOP control effect in early stage,Ex-PRESS implantation shows a lot of advantages over trabeculectomy, such as lower rate of complications,shorter theoretical days of hospitalization, especially much smaller influence on visual acuity. In addition to pure POAG,Ex-PRESS implantation may be especially suit for almost all kinds of secondary OAG and POAG with risk factors.

关 键 词：Ex-PRESS引流钉植入术 小梁切除术 开角型青光眼 

分 类 号：R775[医药卫生—眼科]