房水引流物植入术能否作为青光眼治疗的首选术式

Could tube shunt be as initial surgery for glaucoma management

随着青光眼房水引流物的不断改进和植入技术的逐渐娴熟,房水引流物植入术的应用范围有不断扩大的趋势.至于房水引流物植入术能否成为治疗青光眼的首选术式,目前尚存争议.因此,有必要分析和比较房水引流物植入术与常规小梁切除术的临床疗效,对引流物植入术的适应证及存在分歧的原因进行探讨.多数研究结果表明房水引流物植入术可以作为难治性青光眼的首选术式,其临床疗效优于小梁切除术,其有效性和安全性亦支持扩大应用于非难治性青光眼,但能否取代常规小梁切除术治疗原发性青光眼,目前尚无充分证据支持,尤其还缺乏我国相关的研究数据,尚待多中心的随机临床对照研究结果证实.

Tube shunt or glaucoma drainage device is often used in refractive cases when prior medical or surgical therapy has failed.With improving the biocompatibility of devices＇materials and surgical technique,indications for tube shunt have broadened.This article discusses the update topic that could tube shunt be as initial surgery for glaucoma management？ Based on large varieties of previously published results,tube shunt can be the first choice for refractive glaucoma,however,at prevent there still lack of strong evidences from multi-center randomized clinical trials especially from domestic research to support that tube shunt can substitute primary trabeculectomy for expanded use beyond refractory glancoma.