EX-PRESS青光眼引流器植入术治疗原发性开角型青光眼

EX-PRESS glaucoma filtration device implantation for primary open angle glaucoma

目的观察EX-PRESS青光眼引流器植入术治疗原发性开角型青光眼的临床疗效。方法纳入原发性开角型青光眼患者48例55眼,分为研究组（24例27眼）和对照组（24例28眼）,分别接受EX-PRESS青光眼引流器植入术和小梁切除术。观察并比较手术时间及术后3个月内两组前房、眼压、滤过泡及并发症发生情况。结果研究组的手术时间为（32.40±3.80）min,对照组为（46.64±5.11）min,差异有统计学意义（P〈0.05）。研究组术后1周时有24眼眼压为6-17（10.3±5.3）mmH g（1 kP a=7.5 mmH g）,术后1个月和3个月随访时,眼压均正常,其中1个月时为（9.5±4.8）mmH g,3个月时为（9.4±3.3）mmHg;对照组术后1周时22眼眼压为6-17（10.0±6.2）mmH g,术后1个月时眼压为（13.0±5.5）mmH g,3个月时眼压为（13.4±5.9）mmH g;术后1个月、3个月两组眼压相比差异均有统计学意义（均为P〈0.05）。术后3个月研究组视力恢复程度的构成比优于对照组（P〈0.05）。研究组术后1眼前房出血,对照组5眼且有2眼合并周边脉络膜局限性脱离。研究组术后1眼浅前房并迅速恢复,而对照组15眼浅前房,最迟6 d后恢复。研究组术后功能性滤泡比例较对照组高。结论 EX-PRESS青光眼引流器植入治疗原发性开角型青光眼手术时间更短,术后眼压控制更理想,术后并发症更少,可结合患者经济情况推荐使用。

Objective To observe the clinical effects of EX-PRESS glaucoma filtration device for primary open angle glaucoma. Methyls A total of 55 eyes of 48 patients diagnosed as primary open angle glaucoma were included and divided into two groups. The experimental group consisted of 27 eyes from 24 patients and the control group consisted of 28 eyes from 24 patients. The experimental group received EX-PRESS glaucoma filtration device implantation,and the control underwent the traditional trabeculectomy. The operation time, incidence of shallow anterior chamber, intraocular pressure （IOP）, type of filtering bleb and complication were compared between two groups. Results The operation time of the experimental group was （ 32.40 ± 3.80） minutes, and the control group was （46.54 ± 5.11 ） minutes, there was statistical difference （P 〈 0. 05 ）. In the experimental group, IOP of 24 eyes was 6 - 17 （ 10.3 ± 5.3 ） mmHg （ 1 kPa = 7. 5 mmHg） at postoperative 1 week, which at postoperative 1 month and 3 months were （9. 5 ± 4. 8 ） mmHg and （ 9.4 ± 3.3 ） mmHg, respectively. In the control group ,IOP of 22 eyes was 6 - 17 （ 10.0 ± 6.2 ） mmHg at postoperative 1 week, which at postoperative 1 month and 3 months were （ 13.0 ± 5.5 ） mmHg and （ 13.4 ± 5.9 ） mmHg, respectively, there were statistical differences in IOP at postoperative 1 month and 3 months between two groups （ all P 〈 0.05）. One case of hyphema was observed in the experimental group, and 5 cases in the control group with 2 cases of peripheral local choroid detachment. Shallow anterior chamber was observed only in 1 case in the experimental group and 15 cases in the control group （ lasting 5 days to recover）. The rate of functional filtering bleb in the experimental group was higher than that in the control group （P 〈 0.05 ）. Conclusion The EX-PRESS glaucoma filtration device implantation for open angle glaucoma achieve a shorter operation time and better intraocular pressure control with fewer complications.