非穿透性小梁手术联合醛化脐带静脉管植入及MMC治疗POAG

Clinical effect of non-penetrating trabecular surgery with human umbilical vein implant and mitomycin C for treatment of primary open angle glaucoma

目的:评价非穿透性小梁手术(non-penetrating trabecular surgery,NPTS)联合醛化脐带静脉管(human umbilical vein,HUV)植入和丝裂霉素C(mitomycin C,MMC)治疗原发性开角型青光眼(primary open angle glaucoma,POAG)的临床疗效。方法:对42例42眼POAG患者进行NPTS联合HUV植入和MMC治疗。术后观察指标包括:术后眼压、术后抗青光眼药物应用、术后滤过泡形态学以及术后并发症,随访时间12mo。结果:术后12 mo,手术完全成功81%,条件成功95%;眼压从术前(26.1±7.7)mmHg降至(15.3±3.8)mmHg(P=0.00);抗青光眼药物从术前(3.2±0.5)种减少到(0.3±0.2)种(P=0.00);滤过泡形态,Ⅰ型滤过泡26%,Ⅱ型滤过泡59%,Ⅳ型滤过泡14%。术后6眼出现包裹性滤过泡,3眼有轻微前房出血,无浅前房、低眼压和脉络膜脱离等并发症发生。结论:NPTS联合HUV植入和MMC治疗POAG,具有手术成功率高,术后IOP控制良好,术后并发症发生率低的特点。

AIM：To evaluate the clinical effect of non - penetrating trabecular surgery （NPTS） with human umbilical vein （HUV） implant and mitomycin C （MMC） in patients with primary open angle glaucoma （POAG）. METHODS： NPTS with HUV implant and MMC was performed on 42 eyes of 42 patients with POAG. The outcome＇s evaluation included postoperative intraocular pressure（lOP）, number of anti-glaucoma medications, the morphologic characteristics of the filtering blebs and complications. All patients were followed up for 12 months. RESULTS：The postoperative complete success rate was 81% and qualified success rate was 95% at 12 months after surgery respectively; lOP was decreased from （26.1 ± 7.7） mmHg to （ 15.3 ± 3.8） mmHg at 12 months （ P = 0. 00）; the number of anti-glaucoma medications was decreased from （ 3.2 ± 0.5） to （0.3 ± 0.2） at 12 months （ P = 0.00）; the morphologic characteristics of the filtering blebs： type Ⅰ was 26%, type Ⅱ was 59%, type Ⅳ was 14%. Encapsulated bleb was observed in 6 eyes and there was a small amount of hyphema that was absorbed in 3 eyes, but the complications such as flat chamber, hypotony and choroidal effusion were not observed. CONCLUSIONS： NPTS with HUV implant and MMC might improve the clinical outcome of the patients with POAG, such as higher success rates, lower postoperative mean IOP, and less complication rates.