深部巩膜切除术联合醛化脐带静脉管或透明质酸钠生物胶治疗POAG

Deep sclerectomy augmented with human umbilical vein or reticulated hyaluronic acid for primary open angle glaucoma

目的:评价醛化脐带静脉管(human umbilical vein,HUV)在深部巩膜切除术(deep sclerectomy,DS)中治疗原发性开角型青光眼(primary open angle glaucoma,POAG)的临床疗效。方法:采用前瞻性随机对照临床试验研究,将39例39眼POAG患者分为两组,HUV组19例行DS联合HUV植入;透明质酸钠生物胶(reticulated hyaluronic acid implant,SKGEL)组20例行DS联合SKGEL植入。术后观察、比较的指标包括:术后眼内压(intraocular pressure,IOP)、抗青光眼药物使用数量以及术后并发症。所有研究对象随访12mo。结果:术后12mo,手术完全成功:HUV组79%,对照组80%。术后12mo,HUV组和SKGEL组IOP分别从术前39.9±9.3mmHg和38.4±7.7mmHg降至17.5±0.4mmHg和17.7±0.6mmHg(P=0.55)。HUV组和SKGEL组术后早期分别出现低眼压3例;HUV组出现包裹性滤过泡2例,SKGEL组出现3例。结论:在12mo随访期间,DS联合HUV植入和DS联合SKGEL植入在降低POAG患者IOP和减少抗青光眼药物使用方面具有相同的作用。

AIM：To investigate clinical outcomes of the deep sclerectomy（DS） and human umbilical vein（HUV） transplantation for primary open angle glaucoma（POAG）.METHODS：Thirty-nine patients 39 eyes with POAG were involved in this prospective and random trial.DS with HUV transplantation group was performed in 19 patients and DS with reticulated hyaluronic acid implant（SKGEL） transplantation group in 20 patients.The postoperative indexes included postoperative intraocular pressure（IOP）,the number of antiglaucoma medications,and postoperative complications.All patients were followed up for 12 months.RESULTS：The postoperative complete success rate was 79% in HUV group and 80% in SKGEL group at 12 months.IOP decreased from 39.9±9.3mmHg and 38.4±7.7mmHg preoperatively in HUV and SKGEL groups to 17.5±0.4mmHg and 17.7±0.6mmHg at 12 months respectively（P=0.55）.Early postoperative hypotony occurred in 3 HUV and 3 SKGEL patients.Encapsulated bleb was observed 2 in HUV group and 3 in SKGEL group.CONCLUSION：DS with HUV transplantation and DS with SKGEL transplantation are similarly effective in lowering IOP and reducing the need for antiglaucoma medications over a 12-month follow-up period.