Ex-press青光眼引流器的临床应用观察

Efficacy and safety of Ex-press glaucoma drainage device

目的观察Ex-press青光眼引流器治疗青光眼的有效性及安全性。方法收集2014年1月至2016年5月于安徽医科大学第二附属医院眼科确诊为开角型或复杂性青光眼患者26例(30只眼)。患者年龄14~56岁,最佳矫正视力0.01~0.8,眼压22~56 mmHg。收集术前和术后的视力、眼压、角膜内皮细胞计数的数据以及滤过泡瘢痕化等并发症的情况,并进行统计分析,评价Ex-press青光眼引流器的疗效及安全性。结果术前与术后平均视力比较,均无统计学意义(P>0.05)。术前平均眼压(27.9±8.86)mmHg,术后3 d、1周、1、3和6个月平均眼压分别为(14.2±4.39)mmHg、(14.0±3.65)mmHg、(14.3±3.63)mmHg、(14.5±3.69)mmHg和(14.4±3.68)mmHg,术后各时间点较术前眼压均有统计学差异(P<0.01)。术前平均角膜内皮细胞计数(2620.2±135.3)个/mm^2,术后3个月、6个月平均角膜内皮细胞计数(2521±164.3)、(2474±224.9)个/mm^2,角膜内皮仅有轻微的影响,差异无统计学意义(P>0.05)。术后观察术区滤过泡情况,40%患者术后滤过泡为Ⅰ型,56.7%患者术后滤过泡为Ⅱ型,3.3%患者滤过泡为Ⅲ-Ⅳ型,术后滤过泡情况满意。有5例患者术后浅前房,4例患者术后出现滤过泡包裹并且其中1例为非功能性滤过泡。结论 Ex-press青光眼引流器植入术对开角型及复杂性青光眼的治疗安全有效,临床上值得推广使用。

Objective To observe the efficacy and safety of Ex-press glaucoma drainage device in treatment for glaucoma. Methods We collected the data from patients who were diagnosed with open angle glaucoma or refractory glaucoma in the Second Hospital of Anhui Medical University from January 2014 to may 2016. Subjects included 25 patients （ 30 eyes） aged from 14 to 56 years old, with BCVA between 0. 01 and 0. 8 and lOP between 22 and 56 mmHg. To evaluate the efficacy and safety of Ex-press glaucoma drainage device, we compared BCVA, IOP, corneal endothelium cell count, and glaucoma filtering bleb before and after treatment. Results There was no significant changes in BCVA after Ex-press device treatment. Postoperative IOP significantly reduced since day 3 （ 14. 2 ±4. 39 mmHg ） after the surgery when compared to baseline IOP （27.9 ±8. 86 mmHg; P 〈0. 01 ）. Corneal endothelium cell count was 2620. 2 ±135.3 before treatment and 2521± 164. 3 at 3 months and 2474 ±224. 9 at 6 months after surgery. There was no difference （ P 〉 0. 05 ）. The filtering blebs were perfect. Most were type I （ 40% ） or type II （ 56. 7% ）. Complications included shallow anterior chamber （ n = 5 ） , wrapped filtering bleb （ n = 4 ） , nonfunctional filtering bleb （ n = 1 ）. Condusions Ex- press glaucoma drainage device is a effective and safe device for the open angle glaucoma or refractory glaucoma.