XEN凝胶引流管植入治疗原发性开角型青光眼的初步疗效观察  

Efficacy of XEN Gel Stent Implantation in the Treatment of Primary Open-angle Glaucoma

作　　者：胡甜 张虹[1] 王军明[1] 王琳颢 成前悦 Hu Tian;Zhang Hong;Wang Junming(Department of Ophthalmology,Tongji Hos pital,Tongji Medical Col lege,Huazhong University of Science and Tech nology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,武汉430030

出　　处：《华中科技大学学报（医学版）》2023年第3期351-355,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家自然科学基金资助项目(No.82070965)。

摘　　要：目的初步评估XEN凝胶引流管植入术在原发性开角型青光眼(POAG)治疗中的有效性及安全性。方法回顾性分析2020年1月至2022年3月就诊于华中科技大学同济医学院附属同济医院的8例(10眼)进行了XEN凝胶引流管植入术的患者,其中男性6例(8眼),女性2例(2眼)。年龄分布24~41岁,平均(33.9±5.9)岁。比较手术前后各项指标的变化,包括视力、眼压、青光眼用药数量及术后并发症。结果8例患者均诊断为原发性开角型青光眼,平均随访时间为(13.0±3.9)个月。术前平均眼压为(24.7±6.2)mmHg,末次随访时平均眼压为(13.9±1.7)mmHg,较术前下降了43.7%。术前平均用药数量为3.1种,末次随访时为0.2种。4眼(40%)进行了滤过泡分离手术,其中1眼发生色素颗粒阻塞引流管出口,行滤过泡分离时清除阻塞物,房水顺利流出。截至末次随访,3眼获得手术完全成功,5眼获得部分成功,总成功率为80%。2眼术后发生前房积血,均在术后1个月内自行消退。其余患者未发生其他严重并发症。结论XEN凝胶引流管植入术是POAG的一种有效的外科治疗方法,在1年的随访中,患者眼压和青光眼用药数量显著降低。Objective To preliminarily evaluate the efficacy and safety of XEN gel stent implantation in the treatment of primary open-ang le g laucoma(POAG).Methods A retrospective analysis was performed,including eight patients(10 eyes)in Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology from January 2020 to March 2022.All the patients had been treated with XEN gel stent implantation,including 6 males(8 eyes)and 2 females(2 eyes).The age distribution ranged from24 to 41 years old,with an averageof 33.9±5.9 years old.Preoperative and postoperative visual a-cuity,intraocular pressure,number of glaucoma medications,and surgical complications were assessed.Results All the pa tients were diagnosed with primary open-angle glaucoma,and the mean follow-up time was 13.0±3.9 months.The preoperative aver-age intraocular pressure(IOP)was 24.7±6.2 mmHg,which decreased to 13.9±1.7 mmHg at the last follow-up,with a decrea-sing rate of 43.7%.The average number of preoperative medications was 3.1,and at last follow-up was 0.2.Four eyes(40%)underwent filter bleb commissurotomy,and 1 eye had pigmented tissue blocking the outlet of the stent.The obstruction was re-moved during filter bleb commissurotomy,and the aqueous humor flowed out smoothly.As of the last follow-up,3 eyes achieved complete success,and 5 eyes achieved qualified success,with a total success rate of 80%.Hyphema post-surgery occurred in 2 eyes,which was resolved spontaneously within 1 month.No other serious complications occurred in the other pa-tients.Conclusion XEN gel stent implant is an effective surgical treatment for POAG,with significant reduction in IOP and glaucoma medications at 1 year follow-up.

关 键 词：原发性开角型青光眼 XEN凝胶引流管 微创青光眼手术 

分 类 号：R775[医药卫生—眼科]