EX-PRESS青光眼引流钉植入术和小梁切除术治疗原发性开角型青光眼的临床观察  

Comparison of EX-PRESS glaucoma shunt versus trabeculectomy in the treatment for primary open-angle glaucoma

作　　者：孙荣[1] 周霞[1] 袁均[1] 邓莹莹[1] 

机构地区：[1]湖北省十堰市太和医院眼科,442000

出　　处：《临床眼科杂志》2015年第2期147-149,共3页Journal of Clinical Ophthalmology

摘　　要：目的：与小梁切除术对比，观察EX-PRESS青光眼引流钉植入术治疗原发性开角型青光眼的有效性和安全性。方法对药物不能控制的原发性开角型青光眼患者进行手术，随机分为EX-PRESS青光眼引流钉植入术组和小梁切除术组，每组术中均联合使用丝裂霉素。收集术前，术后1 d，2周，1，3，6，12个月的视力、眼压等基本数据。结果评价主要为平均眼压和术后并发症的发生率。手术完全成功的标准为：在不使用任何降眼压药物的情况下，眼压控制在5～18 mmHg或比基线眼压下降20％。结果28例原发性开角型青光眼患者共32只眼纳入研究，每组各14例。 EX-PRESS青光眼引流钉植入组术前平均眼压（34．5±5．6） mmHg，小梁切除术组术前平均眼压（33．8±6．8） mmHg。两组比较无差异（ P ＞0．05）。术后1年两组平均眼压分别为（12．6±4．5） mmHg和（11．5±4．6） mmHg。两组比较无差异（ P ＞0．05）。术后随访1年，完全成功者EX-PRESS青光眼引流钉植入组占69％，小梁切除术组占56％。相对成功者两组分别占87％和81％。两组比较无差异（ P ＞0．05）。在手术时间和并发症发生率上两组比较无明显统计学差异。结论对于原发性开角型青光眼患者，巩膜瓣下植入EX-PRESS青光眼引流钉装置安全、有效。Objective To compare the efficacy and safety of Ex-PRESS glaucoma shunt with that of standard trab-eculectomy.Methods Patients with medically uncontrolled open-angle glaucoma randomly received either trabeculectomy or Ex-PRESS shunt, both with mitomycin-C.Standardized data collection sheets were completed at baseline and postopera-tive 1 day, 1 week, 2 weeks, 1 month, 3 months, 6 months and 12 months.The main outcomes were mean intraocular pressure （IOP） and incidence of complications.Complete success was defined as an IOP between 5 and 18mmHg and a 20%reduction in IOP from baseline without medication.Results There were 28 patients （32 eyes） with primary open-angle glaucoma enrolled in the study.Fourteen received EX-PRESS shunt and the other 14 received trabeculectomy.Base-line IOP was 34.5 ±5.6 mmHg and 33.8 ±6.8 mmHg （ P 〉0.05） respectively, and 1-year mean IOP was 12.6 ±4. 5mmHg and 11.5 ±4.6 mmHg （ P 〉0.05） respectively.At 1-year follow-up, complete success rate was 69% versus 56%（ P 〉0.05）.Qualified success rate was 87% versus 81% （ P 〉0.05）.There were no statistically significant differences in operation time and complications between the Ex-PRESS groups and trabeculectomy group.Conclusion Ex-PRESS is a safe and effective device for treating primary open-angle glaucoma.

关 键 词：EX-PRESS青光眼引流钉 小梁切除术 眼内压 青光眼 

分 类 号：R779.6[医药卫生—眼科]