Ex-press青光眼引流钉植入术治疗难治性青光眼的疗效分析

Clinical effect of Ex-press glaucoma value implantation for the treatment of refractory glaucoma

目的：探讨Ex-press青光眼引流钉植入术治疗难治性青光眼的临床疗效与安全性。方法：回顾性分析行Ex-press青光眼引流钉植入术治疗的难治性青光眼患者22例23眼。观察术前及术后1wk,1、2、3、6mo,1a的视力、眼压及并发症发生情况。结果：所有患者均随访至1a。完全成功率为52%（12眼）,部分成功率22%（5眼）,总成功率74%。术前平均眼压为40.59±11.11mmH g（1mmH g=0.133k Pa）,术后1wk,1、2、3、6mo,1a的平均眼压分别为10.30±5.07、12.23±4.03、13.87±4.62、16.52±6.09、18.35±7.06、19.65±8.26mmH g。术后各时间点眼压与术前眼压相比均有统计学意义（P〈0.01）。术后患者视力较术前提高,差异有统计学意义（P〈0.01）。23眼中3眼出现少量前房出血,分别于术后4~7d自行吸收;2眼出现一过性低眼压,密切观察8~10d后眼压〉6mmH g;1眼术后1mo出现渗出性脉络膜脱离,给予局部使用激素后于术后37d复位。所有患者均未出现其他并发症。结论：Ex-press青光眼引流钉植入术治疗难治性青光眼安全有效。

AIM：To explore the safety and efficacy of Ex-press glaucoma value implantation for the treatment of refractory glaucoma.METHODS：The data of 22 patients（23 eyes） with refractory glaucoma received implantation of Ex- press glaucoma value were retrospectively analyzed.The visual acuity,intraocular pressure（IOP） and complications in all patients were observed before and after operation in 1wk,2mo,3mo,6mo and 12 mo.RESULTS：All patients were followed up for 1y.The complete success rate was 52%（12 eyes）,the partial success rate was 22%（5 eyes） and the total success rate was 74%.The IOP of preoperative and postoperative 1wk,1mo,2mo,3mo,6mo,and 12 mo was 40.59±11.11,10.30±5.07,12.23±4.03,13.87±4.62,16.52±6.09,18.35±7.06 and 19.65 ± 8.26 mmHg,（1mmHg =0.133 KPa）respectively.Postoperative IOP at every time point was significantly decreased compare to preoperation（P〈0.01）.The visual acuity was significantly improved postoperatively（P〈0.01）.Postoperative hyphema were found in 3 eyes,transient low IOP in 2 eyes,and choroids detachment in 1 eye.All of these complications appeared at the early postoperative stage and healed within 4-14 d.No other complications were observed.CONCLUSION：Ex-press glaucoma value implantation seemed to be one of the most safe and effective way in treatment of refractory glaucoma.