房角镜辅助的内路小梁切开术治疗青少年型开角型青光眼与原发性开角型青光眼12个月疗效对比  

Comparison of 12-month efficacy of gonioscopy-assisted transluminal trabeculotomy for juvenile open-angle glaucoma and primary open-angle glaucoma

作　　者：郑汇聪 杨天予 张健 桑景荭 辛晨 王怀洲 Zheng Huicong;Yang Tianyu;Zhang Jian;Sang Jinghong;Xin Chen;Wang Huaizhou(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730)

机构地区：[1]首都医科大学附属北京同仁医院/北京同仁眼科中心眼科学与视觉科学北京市重点实验室,北京100730

出　　处：《眼科》2024年第4期275-279,共5页Ophthalmology in China

摘　　要：目的比较青少年型开角型青光眼与原发性开角型青光眼行房角镜辅助的内路小梁切开术(GATT)的治疗效果差异。设计前瞻性队列研究。研究对象2018年3月至2019年8月于北京同仁医院就诊并手术的青少年型开角型青光眼(JOAG)患者37例(44眼)及原发性开角型青光眼(POAG)患者25例(31眼)。方法对均施行GATT术的两组患者进行前瞻性观察12个月,比较术后眼压、降眼压药物使用数量。主要指标术后眼压、条件成功率、完全成功率等。条件成功定义为应用降眼压药物下,眼压≤21mmHg。完全成功定义为不使用抗青光眼药物情况下随访眼压≤21mmHg。结果术后12个月,JOAG和POAG两组患者的眼压均较术前显著下降(JOAG组t=6.564,P<0.001;POAG组t=3.624,P=0.001),降眼压药物使用数量均明显较术前减少(t=16.386、7.977,P均<0.001)。术后3个月两组患者完全成功率分别为81.8%和61.3%,具有统计学差异(χ^(2)=3.919,P=0.048),术后1、6、12个月两组完全成功率无显著差异,术后1、3、6、12个月两组条件成功率也均无统计学差异,两组间术后12个月累积完全成功率和累积条件成功率均无显著差异。73眼(97.3%)出现术后早期并发症,主要为术后高眼压(JOAG:63.64%,POAG:51.61%),前房积血(JOAG:79.55%,POAG:90.32%),且无显著差异。两组患者术后12个月随访均未发现严重并发症。结论随访12个月的结果表明,GATT治疗JOAG与POAG患者有效且效果和安全性无显著差异。Objective To explore the 12-month efficacy of gonioscopy-assisted transluminal trabeculotomy(GATT)for juvenile open-angle glaucoma(JOAG)and primary open-angle glaucoma(POAG).Design Prospective study.Participants 37 patients(44 eyes)with JOAGand 25 patients(31 eyes)with POAG were enrolled from March 2018 to August 2019 in Beijing Tongren Hospital.Methods Prospective comparison of 12-month clinic outcome of GATT on JOAG and POAG.Main Outcome Measures Included intraocular pressure(IOP),the number of glaucoma medications,surgical success rate,and occurrence of complications.Success was defined as an IOP of≤21 mmHg with(quantified success)or without(complete success)medication.Results At postoperative 12 months,both JOAG and POAG exhibited significant reduction IOP comparing with it preoperatively(JOAG group:t=6.564,P<0.001;POAG group:t=3.624,P=0.001).Additionally,there was a marked decrease in the number of anti-glaucoma medications in both groups(JOAG:t=16.386,P<0.001;POAG:t=7.977,P<0.001).The 3-month complete success rate of JOAG group(81.8%)was significantly higher than that in the POAG group(61.3%)(χ2=3.919,P=0.048).However,there was no significant difference of complete success rate at 1-,6-,and 12-month between two groups.It was the same for 1-,3-,6-,and 12-month qualified success rate between two groups.In general,early postoperative complications occurred in 72(97.3%)eyes.Elevated IOP(63.64%in JOAG and 51.61%in POAG)and hyphema(79.55%in JOAG and 90.32%in POAG)happened most frequently,which were no significant differences between two groups.Conclusion The result of 12 months follow-up showed GATT is equally effective and safe for JOAG and POAG.(Ophthalmol CHN,2024,33:275-279)

关 键 词：房角镜辅助的内路小梁切开术 青少年型开角型青光眼 原发性开角型青光眼 

分 类 号：R779.6[医药卫生—眼科]