XEN凝胶引流管植入术在青光眼治疗中的初步观察  

Efficacy of the XEN gel stent on intraocular pressure lowering in glaucoma patients

作　　者：姚贻华 叶琴[1] 王晓辉[1] 林艳 朱益华[1] Yao Yihua;Ye Qin;Wang Xiaohui;Lin Yan;Zhu Yihua(The First Affiliated Hospital of Fujian Medical University,Fujian Institute of Ophthalmology,Fuzhou 350004,China)

机构地区：[1]福建医科大学附属第一医院眼科,福建省眼科研究所,福州350004

出　　处：《中华眼科杂志》2021年第9期679-684,共6页Chinese Journal of Ophthalmology

基　　金：国家自然科学基金面上项目(81970789);福建省自然科学基金(2020J05251)。

摘　　要：目的初步评估XEN凝胶引流管植入术在青光眼治疗中的疗效及安全性。方法回顾性系列病例研究。纳入2020年1至9月就诊于福建医科大学附属第一医院的8例(8只眼)青光眼患者的临床资料,其中男性6例,女性2例,行XEN凝胶引流管植入术时患者年龄为29~74岁。所有患者经过详细的眼科检查后,均符合XEN植入术的手术适应证。术后随访的观察指标包括眼压、眼前节、眼底、青光眼用药和手术并发症。结果8例患者包括原发性开角型青光眼7例、青光眼睫状体炎综合征1例。5例患者既往接受过抗青光眼手术。XEN凝胶引流管植入术均由同一术者完成,所有患者术中均顺利植入XEN凝胶引流管,术后随访4~12个月。8例患者术前最高眼压为11~44 mmHg(中位数为28 mmHg)(1 mmHg=0.133 kPa),末次随访眼压为10~18 mmHg(中位数为13 mmHg)。术前青光眼用药为2~4种(中位数为3种),末次随访时青光眼用药为0~2种(中位数为0种)。截至末次随访,手术完全成功7例,手术失败1例。2例患者术中出现前房出血,给予积极处理后眼压下降至20 mmHg以下。1例患者因术后3个月引流管阻塞导致眼压再次升高,接受XEN引流管再通手术后眼压下降,末次随访眼压约10 mmHg,未再使用抗青光眼药物治疗,但按标准评估为手术失败。其余患者无其他严重并发症。结论小样本初步研究结果显示XEN凝胶引流管植入术是治疗青光眼比较安全且有效的手术方式。(中华眼科杂志,2021,57:679-684)Objective To evaluate the efficacy and safety of the XEN gel implant in the treatment of glaucoma.Methods It was a retrospective case series study.Eight patients(8 eyes)in the First Affiliated Hospital of Fujian Medical University from January 2020 to September 2020 were included,including six males and two females,aged 29 to 74 years.The patients treated with the XEN gel implanting for glaucoma.After detailed ophthalmic examination,all the patients met the surgical indications for the XEN gel implanting.Preoperative and postoperative intraocular pressure(IOP),anterior segment and fundus examination results,medication,and surgical complications were evaluated.Results There were seven patients with primary open-angle glaucoma and one patient with glaucomatocyclitic syndrome.Five patients had received anti-glaucoma surgeries,and the remaining three patients had not received surgical treatment.All XEN gel stents were implanted successfully.All patients were followed up for 4 to 12 months.The preoperative maximum IOP ranged from 11 to 44 mmHg(median,28 mmHg,1 mmHg=0.133 kPa),and the IOP was 10 to 18 mmHg(median,13 mmHg)at the last follow-up.Two to 4 types of medication were used for glaucoma preoperatively(median,3),while 0 to 2 types(median,0)were used at the last follow-up.During the follow-up,7 cases were completely successful and only one case failed.Intraoperative hemorrhage occurred in two patients,and after effective treatment,the IOP decreased to below 20 mmHg.One patient was found to have an increased IOP with the XEN luminal obstruction,and the XEN drainage tube was recanalized.The IOP was about 10 mmHg at the last follow-up,and no anti-glaucoma drugs were used,but the surgery was assessed as failure by standard.The remaining patients had no other serious complications.Conclusion This preliminary study shows that the XEN gel drainage may be a safe and effective treatment for patients with glaucoma.(Chin J Ophthalmol,2021,57:679-684)

关 键 词：青光眼 青光眼引流植入物 眼外科手术 凝胶类 治疗结果 

分 类 号：R779.6[医药卫生—眼科]