摘要
目的:评价药物治疗无效的开角型青光眼及部分复杂性青光眼行二氧化碳激光辅助下外层Schlemm管消融术(CO_2 laser-assisted sclerectomy surgery,CLASS)的短期临床安全性及有效性。方法:收集2015年5月至2016年1月解放军总医院眼科行CLASS手术和小梁切除手术的青光眼患者各23例,共46例46只眼。观察术后1周、1个月和3个月眼压及并发症发生情况。结果:两组术后1周、1个月及3个月眼压较术前均明显下降(P=0.000)。术后1周、1个月及3个月时CLASS手术组眼压平均值均低于小梁切除术组,但无统计学差异(P>0.05)。CLASS手术组23例均无浅前房、脉络膜脱离等并发症出现。小梁切除手术组有4例在术后早期出现浅前房,其中1例出现脉络膜脱离,经治疗后均治愈。结论:CLASS手术在有效降低眼压的同时,能大幅降低患者术后出现浅前房等并发症的概率,但其远期降眼压效果及并发症发生情况有待进一步深入研究。
Objective： To evaluate the short-term of clinical safety and efficiency of CO2 laser-assisted sclerectomy surgery （CLASS） in patient with open-angle glaucoma and complicated glaucoma. Methods： Our study involved 46 eyes of 46 patients with glaucoma that underwent CLASS and trabeculectomy respectively by the same surgeon （Zhaohui Li） from May 201S to January 2016 at the PLA General Hospital. Intraocular pressure and complications 1 week, 1 month and 3 months after operation was observed separately. Results： The intraocular pressure （IOP） 1 week, 1 month and 3 months after surgery decreased obviously （P=0.000）. Compared to the trabeculectomy group i week, 1 month and 3 months after surgery, IOP of CLASS group was lower. But there was no statistically significant difference between these two groups （P〉0.05）. There was no complication occurred in CLASS group. Early postoperative complications occurred in trabeculectomy group induded shallow anterior chamber and choroidal detachment, and they were all successfully resolved by pharmacotherapy. Conclusion： CLASS operation could reduce intraocular pressure effectively and decrease the incidence of complications, such as postoperative shallow anterior chamber in patients with glaucoma. However, its long-term effect and complications need to be further studied.
