EX-PRESS青光眼引流器植入术治疗开角型或复杂型青光眼疗效分析  

The Effect of EX-PRESS Glaucoma Shunting Device Implantation for Glaucoma

作　　者：董晓飞[1] 刘伟 关玲[1] DONG Xiao-fei;LIU Wei;GUAN Ling(Department of Ophthalmology, First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei, China;Department of Glaucoma, Eye Hospital, Tianjin Medical University, Tianjin 300384, China)

机构地区：[1]秦皇岛市第一医院眼科,河北066000 [2]天津医科大学眼科医院青光眼科,天津300384

出　　处：《中国现代手术学杂志》2020年第1期65-70,共6页Chinese Journal of Modern Operative Surgery

基　　金：秦皇岛市科学技术研究与发展计划项目(201703A138)。

摘　　要：目的探讨EX-PRESS青光眼引流器植入术治疗开角型或复杂型青光眼的疗效。方法选取2013年1月~2018年1月确诊为开角型或者复杂型青光眼患者82例,根据手术方式分为两组,对照组采用小梁切除术(40例44眼),观察组采用EX-PRESS青光眼引流器植入术(42例45眼)。观察并比较两组患者视力、眼压、角膜内皮细胞计数、滤过泡、并发症及手术成功率的情况。结果观察组手术总成功率93.33%,高于对照组的86.36%,组间比较差异有统计学意义(P<0.05)。术后两组患者视力较术前均有显著改善(P<0.05),眼压均明显降低(P<0.05),但两组患者术后1、3、6月视力、眼压比较均无统计学差异(P>0.05)。两组术后角膜内皮细胞数目虽较术前有所降低,但仅对照组术后6月末较术前明显下降(P<0.05),观察组术后各时点、对照组术后1月及3月末较术前均无统计学差异(P>0.05)。术后两组患者手术前后角膜内皮细胞数目比较均无统计学差异(P>0.05),但术后观察组下降率为2.27%,低于对照组的6.67%,差异有统计学意义(P<0.05)。两组各时间点的功能性及非功能性滤过泡情况比较均无统计学差异(P>0.05)。两组患者均未出现晚期低眼压,观察组并发症发生率为8.88%,显著低于对照组的27.27%(P<0.05)。结论EX-PRESS青光眼引流器植入术治疗青光眼安全、有效,对角膜内皮细胞影响较小,降压效果明显,术后并发症少,值得临床推广。Objective To investigate the effect of surgery of EX-PRESS glaucoma shunting device implantation for glaucoma.Methods A total of 82 cases with open angle or complex glaucoma from January 2013 to January 2018 were enrolled in the research and divided into two groups according to the surgical procedure,including 40 cases(44 eyes)performed trabeculectomy(as the control group)and 42 cases(45 eyes)performed EX-PRESS glaucoma shunting device implantation(as the observation group).The visual acuity,intraocular pressure,corneal endothelial cell counts,filtering,success rate and complications were compared between the two groups.Results The total success rate was 93.33%in the observation group,and was significantly higher than 86.36%in the control group(P<0.05).The visual acuity was improved and intraocular pressure was decreased obviously after the surgery than that before the surgery in both groups(P<0.05),but there was no statistical difference in post-operative visual acuity and intraocular pressure in 1,3,6 months between the two groups(P>0.05).The numbers of post-operative corneal endothelial cells were decreased significantly at the end of 6 months than that before the surgery in the control group(P<0.05),but there was no statistical differences between pre-and post-surgery in other time points in both groups and between the two groupsafter surgery(P>0.05).The decrease rate was 2.27%of the observation group,and was lower than 6.67%of the control group(P<0.05).There was no difference in functional and non-functional follicles between the two groups(P>0.05).No ocular hypotension was found in both groups.The incidence of post-operative complication was 8.88%in the observation group,and was lower than 27.27%of the control group,and the differences was significantly(P<0.05).Conclusion The implantation of EX-PRESS glaucoma drainage device is safe and effective for glaucoma with mild effect on corneal endothelial cells,obvious antihypertensive effect and less post-operative complications,and it is worthy of clinical gener

关 键 词：青光眼引流器 青光眼 角膜内皮细胞 眼压 

分 类 号：R775[医药卫生—眼科]