青光眼睫状体炎综合征青光眼引流器植入术的效果

The clinical effects of Ex-PRESS glaucoma drainage device implantation for the treatment of glaucomato-cyclitic syndrome

目的：评价Ex-PRESS引流器植入术治疗青光眼睫状体炎综合征（ glaucomato-cyclitic syndrome,GCS）的临床疗效和安全性。方法回顾性分析在我院行引流器植入术治疗的GCS 22例（23眼）的病例资料,观察术后1周及最后随访时（术后12-36个月）的视力和眼压、用药种类和眼底杯盘比、发作次数、并发症和手术成功率。结果术前视力分别与术后1周及最后随访时的视力相比,差异均无统计学意义；术前、术后1周及最后随访时眼压平均值分别为：（31.23±9.39） mmHg、（9.00±4.73） mmHg及（14.00±2.52） mmHg（1 mmHg=0.133 kPa）,相互之间差异均有统计学意义（P〈0.01）。最后随访时使用降眼压药物为（0.54±0.78）种比术前的（2.69±1.65）种显著减少,差异有统计学意义（t=5.112,P=0.002）；术前和最后随访时杯盘比分别为：（0.72±0.09）和（0.72±0.10）,差异无统计学意义（t=-1.000,P=0.087）。术后每年发作（2.85±1.52）次比术前的（4.31±1.25）次减少（t=5.019,P=0.006）。最后随访时的手术总成功率为86.96%；23眼均无严重并发症。结论 Ex-PRESS引流器植入术对需要手术治疗的GCS是一种较为安全有效的治疗方法。

Objective To evaluate the clinical efficacy and security of Ex-PRESS glaucoma drainage device implantation for the treatment of glaucomato-cyclitic syndrome （ GCS ） . Methods The clinical data of 23 eyes of 22 patients with GCS received Ex-PRESS glaucoma drainage device implantation in our hospital were retrospectively analyzed. Both the intraocular pressure （ IOP） and visual acuity at 1 week after the operation and the last follow-up time（12-36 months after operation） were recorded. The kinds of anti-glaucoma medications before and after the surgery, cup to disk ratio, attack frequency every year, complications and surgical success rate were statistically analyzed. Results The IOP before operation, 1 week after the operation and at the last follow-up time were（31. 23 ± 9. 39） mmHg,（9. 00 ± 4. 73） mmHg and（14. 00 ± 2. 52） mmHg respectively and there were statistically significant differences among differenet time points（P〈0. 01）. But the visual acuity at those time points had no statistically significant difference. Numbers of anti-glaucoma drugs at last follow-up time was（0. 54 ± 0. 78）, which was less than that of preoperative（2. 69 ± 1. 65） （ t =5. 122, P =0. 002）. The cup to disk ratio was （0. 72 ± 0. 09） at preoperative and（0. 72 ± 0. 10） at last follow-wp time respectively. There was no statistically significant difference （t= -1. 000,P=0. 087）. Attack frequencies every year at the last follow-up time was（2. 85 ± 1. 52） which was lower than that preoperative（4. 31 ± 1. 25） （t=5. 019,P=0. 006）. There were no serious complication during the follow-up time in 23 eyes. Until the last follow-up, the total success rate was 86. 96%. Conclusion Ex-PRESS glaucoma drainage device implantation is an effective and safe method for patients with glaucomato-cyclitic syndrome who need surgical treatment.