非穿透性深度巩膜切除术+MMC Tenon囊下注射治疗开角型青光眼术后高阶像差变化的研究（英文）  

Study of changes in higher-order aberrations following non-penetrating deep sclerectomy surgery augmented with sub-Tenon injection of MMC in patients with open-angle glaucoma

作　　者：Ali Mostafaei Nazli Taheri Atena Latifi Ali Mostafaei;Nazli Taheri;Atena Latifi(Department of Ophthalmology,Research Center for Evidence Based Medicine,Tabriz University of Medical Sciences,Tabriz 5154645395,Iran;Nikoukari Eye Hospital,Tabriz University of Medical Sciences,Tabriz 5154645395,Iran)

机构地区：[1]大不里士医科大学循证医学研究中心眼科,伊朗大不里士5154645395 [2]大不里士医科大学Nikoukari眼科医院,伊朗大不里士5154645395

出　　处：《国际眼科杂志》2019年第11期1811-1818,共8页International Eye Science

摘　　要：目的:研究开角型青光眼患者非穿透性深层巩膜切除术后高阶像差的变化。方法:研究包括20例患者20眼,其中10例为原发性开角型青光眼,10例为继发性开角型青光眼。患者术前接受非穿透性深层巩膜切除术,并辅以Tenon囊下注射(0.02%of MMC)。术前及术后1、3mo用i-Trace分析仪测定角膜总高阶像差。每次随访时评估眼压(IOP)、最佳矫正视力(BCVA)和眼泡形态。手术的成功率分为完全成功、相对成功和失败。结果:术前IOP为24.05±3.07 mmHg,平均用药2.85±0.67次,随访3mo后,IOP为12.30±3.32 mmHg,平均用药0.70±0.98次。随访期间IOP均明显下降(P<0.001)。术后随访1mo,总高阶像差(HOT)均方根(RMS)和总球型像差值明显升高,3mo后下降。术后各时间段三叶肌和全眼昏迷样像差变化无统计学意义。术后1mo HOT RMS及球形角膜均明显增加,3mo随访后明显减少。术后角膜三叶肌变化与术前相比无统计学意义。患者年龄和IOP对HOT和角膜HOT的变化无显著影响。结论:深度巩膜切除术后1mo内角膜和眼部高阶像差增加,3mo后下降,与术前相比无统计学意义。在3mo随访时,患者的BCVA和等效球镜(SE)与术前相比无统计学差异。AIM: To study the changes in higher-order aberrations following non-penetrating deep sclerectomy surgery augmented with sub-Tenon injection of mitomycin C(MMC) in patients with open angle glaucoma.METHODS: Twenty eyes from 20 patients were enrolled in the study. There were 10 eyes with primary open angle glaucoma(POAG) and 10 eyes with secondary open angle(SOAG;pseudoexfoliation). Patients underwent non-penetrating deep sclerectomy surgery augmented with sub-Tenon injections(0.2 mL of MMC 0.02%) before surgery. All patients were evaluated in terms of corneal total higher-order aberrations via i-Trace analyzer before surgery and 1 mo and 3 mo after surgery. The intraocular pressure(IOP), best corrected visual acuity(BCVA), and bleb morphology were evaluated at each visit. The success rate of surgery was categorized as complete, relative, or failure.RESULTS: The IOP before surgery was 24.05±3.07 mmHg with a mean of 2.85±0.67 medication, which reached to 12.30±3.32 mmHg with 0.70±0.98 medication at the 3 mo follow-up. The reduction in IOP was significant at all periods of the follow-up(P<0.001). The values of total higher-order total(HOT) root mean square(RMS) and total ocular spherical-like aberrations significantly increased at 1 mo follow-up after surgery and decreased over the course of 3 mo. Trefoil and total ocular coma-like aberration changes were not statistically significant at all periods after surgery. The HOT RMS, coma-like and spherical-like corneal increased significantly 1 mo after surgery and decreased at the 3 mo follow-up. Corneal trefoil changes were not statistically significant after surgery compared to preoperative state. Patients age and IOP did not have a significant effect on changes in HOT and corneal HOT aberrations.CONCLUSION: Corneal and ocular higher-order aberrations increased within 1 mo after deep sclerectomy surgery and then decreased over a 3 mo period, which showed no statistically significant change compared to preoperative state. The BCVA and spherical equivalent(SE) of the

关 键 词：高阶相差 眼压 丝裂霉素C 非穿透深层巩膜切除术 

分 类 号：R73[医药卫生—肿瘤]