Ex-PRESS引流器植入术治疗青光眼的临床观察

Clinical observations of Ex-PRESS glaucoma filtration device implantation in patients with glaucoma

目的研究Ex-PRESS引流器植入术对青光眼患者眼内压和角膜内皮细胞数的影响。方法选取收治的62例青光眼患者,对照组患者31例(33眼),行复合式小梁切除术;研究组患者31例(35眼),行Ex-PRESS引流器植入术。结果研究组患者手术总成功率(88.57%)较对照组(66.67%),差异有统计学意义(P<0.05);术后6个月,研究组患者视力改善情况优于对照组,且研究组患者视力提高比例(85.71%)高于对照组(60.61%),差异具有统计学意义(P<0.05);与术前相比,两组患者术后眼压均下降(P<0.05),且术后1、3、6个月研究组患者的眼压低于对照组(P<0.05);术后1、3、6个月两组患者的角膜内皮细胞数较术前均下降(P<0.05),两组患者间角膜内皮细胞数比较差异无统计学意义(P>0.05);研究组患者并发症发生率(17.14%)低于对照组(45.45%),差异有统计学意义(P<0.05)。结论 Ex-PRESS引流器植入术对青光眼患者的角膜内皮细胞数的影响与复合式小梁切除术相当,远期降眼压效果优于小梁切除术。

Objective To explore the ocular hypotensive efficacy of Ex-PRESS glaucoma filtration device implantation in patients with glaucoma and its effect on corneal endothelial cell counts. Methods Sixty-two patients with glaucoma treated at our hospital were divided into the control and research groups. The control group comprised 31 patients （33 eyes） treated with compound trabeculectomy, and the research group comprised 31 patients （35 eyes） treated with Ex- PRESS glaucoma filtration device implantation. Results The total surgical success rate was significantly higher in the research group （88.57%） than in the control group （66.67%; P 〈0.05）. Although the vision of patients in both groups improved significantly at 6 months after the operations （ P 〈 0.05 ）, improvement was significantly better in the research group （85.71%） than in the control group （60.61% ; P 〈0.05）. The intraocular pressure in both groups was significantly lower after operation than before （P 〈 0.05 ）. However, at 1, 3, and 6 months after operation, the in- traocular pressure was significantly lower in the research group than in the control group （ P 〈 0.05 ）. The corneal endo- thelial cell counts in both groups were significantly lower at 1,3, and 6 months after operation than before （ P 〈 0.05 ）. No significant intergroup difference in corneal endothelial cell counts was observed at 1,3, and 6 months after operation （P 〉 0.05 ）. The complication rate was significantly lower in the research group （17.14%） than in the control group （45.45 % ; P 〈 0.05 ）. Conclusion In patients with glaucoma, the long-term effects of Ex-PRESS glaucoma filtration device implantation on intraocular pressure were superior to those of trabeculectomy, and the effects of both treatments on corneal endothelial cell counts were comparable.