POAG手术治疗进展

Progress in surgical treatment for primary open-angle glaucoma

POAG在药物或激光控制眼压无效时常需手术治疗.目前小梁切除术是治疗POAG最主要的手术方法,但其术中、术后并发症较常见,如前房出血、术后浅前房、滤过道纤维化等.随着手术技术的不断改进,许多治疗POAG的新方法逐渐涌现.Ex-PRESS植入术以其手术切口小、术后并发症少以及无需组织切除等特点已逐渐被广泛应用.此外,SOLX黄金分流器、人工纳米引流植入物、iStent小梁微旁路系统、Eyepass双向青光眼植入物、Aquaflow青光眼植入物、Schlemm＇s管成形术、小梁消融术等也分别从不同角度用于POAG的治疗.

Surgical treatment tends to be the best choice for primary open-angle glaucoma （POAG） patients after medication or laser therapy fails to control intraocular pressure effectively.Trabeculectomy is currently the leading surgery for POAG even though it has complications such as hyphema,hypotony,and bleb scarring,which are commonly observed during or after operations.With the gradual improvement in surgical techniques,some new surgeries for POAG have been introduced recently.The Ex-PRESS glaucoma filtration device has been developed successfully and is in widespread use for decreasing intraocular pressure.This device is unique because it features small incision surgery and fewer complications as well as no tissue removal.Moreover,the gold micro shunt implant,artificial nano drainage implant,Glaukos iStent trabecular micro-bypass,Eyepass glaucoma implant,AquaFlow collagen implant,canaloplasty and trabectome are often performed in different aspects of POAG treatments.All of these new surgical methods are reviewed in detail.