P50型与P200型Ex-PRESS引流器植入术对开角型青光眼疗效及安全性的随机对照研究  

Early effectiveness of P50 and P200 Ex-PRESS glaucoma drainage device implantation for open angle glaucoma：a randomized controlled study

作　　者：韩光杰[1] 周和政[1] 张文强[1] 江文珊[1] 刘川[1] 

机构地区：[1]广州军区武汉总医院全军眼科中心,武汉430070

出　　处：《中华实验眼科杂志》2015年第3期246-249,共4页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景 目前国外对Ex-PRESS引流器植入术治疗开角性青光眼的临床应用效果已有报道,在中国临床上使用的Ex-PRESS引流器有内径分别为50μm和200μm的P50型和P200型,但2种类型引流器的临床效果是否有所不同,目前国内外报道较少. 目的 对比观察P50型与P200型Ex-PRESS引流器植入术治疗开角型青光眼的早期临床疗效和安全性. 方法 采用随机对照临床研究设计,纳入2012年3月至2013年4月在广州军区武汉总医院行Ex-PRESS引流器植入术的开角型青光眼患者69例80眼,采用随机数字表法将患者分为基线特征匹配的2个组,分别实施P50型Ex-PRESS引流器植入术（35例40眼）和Ex-PRESS引流器植入术（34例40眼）,比较2个组患者的病种构成比、最佳矫正视力恢复时间、理论住院天数、手术前后的眼压变化及并发症的发生情况.结果 P50组和P200组术眼手术前后眼压平均下降幅度分别为（21.19±11.22）和（24.35±12.27）mmHg（1 mmHg=0.133 kPa）,差异无统计学意义（t=-1.201,P＞0.05）.P50组患者的理论住院天数和最佳矫正视力恢复时间分别为（3.65±0.92）d和（2.85±0.95）d,明显少于P200组的（4.90±0.81）d和（3.40±0.96）d,差异均有统计学意义（t=-6.444,P＜0.01;t=-2.584,P＜0.05）.P50组和P200组术眼术后并发症发生率分别为6.06％和25.00％,差异有统计学意义（x2=9.800,P＜0.05）,P50组术眼发生低眼压和浅前房的跟数少于P200组.结论 P50型和P200型Ex-PRESS引流器植入术对开角性青光眼的降眼压作用接近,与P200型Ex-PRESS引流器植入术比较,P50型Ex-PRESS引流器植入后早期患者的视力恢复快,并发症的发生率低.Background Ex-PRESS glaucoma drainage device implantations have been clinically applied worldwide.In China,50 type and 200 type of Ex-PRESS glaucoma drainage devices are used for different types of open angle glaucoma.However,whether the clinical outcomes are similar between 50 type and 200 type of Ex-PRESS glaucoma drainage devices are not elucidated.Objective This study was to compare the therapeutic efficacy and security of Ex-PRESS implantation between PS0 type and P200 type of Ex-PRESS glaucoma drainage devices for open angle glaucoma Methods A randomized,parallel-group trial was designed,and written informed consent was obtained from each patient prior to entering in the cohort.Eighty eyes of 69 patients with various types of open angle glaucoma were included from March 2012 to April 2013 in Wuhan General Hospital of Guangzhou Military Command.The patients were randomized into 2 groups according to randomized digital table.The P50 type Ex-PRESS glaucoma drainage device was implanted in 40 eyes of 35 patients in the P50 group,and P200 type was implanted in 40 eyes of 34 patients in the patients of the P200 group.The disease composition,best corrected visual acuity （BCVA） recovery time,theoretical hospitalization days,lowing intraocular pressure （IOP） range and postoperative complications were compared between the two groups.Results The average lowing-IOP ranges of the P50 type group and P200 type group were （21.19±11.22） and （24.35±12.27） mmHg,respectively,with an insignificant difference between them （t =-1.201,P＞0.05）.The theoretical hospitalization days and BCVA recovery time in the of P50 type group were （3.65±0.92） days and （2.85±0.95）days,and those in the P200 type group were （4.90±0.81） days and （3.40± 0.96） days,showing significant decreases in the P50 type group （t =-6.444,P＜0.01 ;t =-2.584,P＜ 0.05）.The incidence of postoperative complications were 6.06％ and 25.00％ in P50 type group and P200 type group,respectively,with a significant difference

关 键 词：开角型青光眼/手术 青光眼引流植入物 微型化 眼压 治疗效果 术后并发症 Ex-PRESS引流器 随机对照研究 

分 类 号：R779.6[医药卫生—眼科]