EX-PRESS引流钉联合生物羊膜植入术治疗POAG的疗效及安全性

Effect and safety of EX-PRESS shunt implantation combined with biological amniotic membrane implantation for primary open angle glaucoma

目的:分析EX-PRESS引流钉联合生物羊膜植入术治疗原发性开角型青光眼(primary open angle glaucoma,POAG)的有效性及安全性。方法:回顾性分析2015-01/2017-02在我院接受EXPRESS引流钉(P50)+羊膜植入术(31例38眼,试验组)与单纯EX-PRESS引流钉(P50)植入术(22例34眼,对照组)患者的临床资料,统计分析两组术前,术后1d,1wk,3、6mo眼压变化、滤过泡情况以及并发症发生率。结果:术后各个时间点上,试验组及对照组的平均眼压均较术前明显下降,其差异有统计学意义(P<0.05),术后1d,1wk,试验组与对照组平均眼压差异无统计学意义(P>0.05),在术后3、6mo,对照组眼压较试验组眼压高,其差异有统计学意义(P<0.05)。在术后3mo,试验组中功能性滤过泡比例较对照组高,其差异有统计学意义(P<0.05),试验组和对照组术后并发症主要包括浅前房、出血、虹膜后粘连、角膜水肿,两组中其发生率差异无统计学意义(P>0.05)。结论:EX-PRESS引流钉植入术联合生物羊膜植入可以安全有效降低眼压,改善术后滤过泡情况,并有远期降低眼压的作用。

AIM:To analyze the curative effect and safety in early stage primary open angle glaucoma(POAG)between simple Ex-PRESS shunt implantation and its combination with biological amniotic membrane implantation.METHODS:The clinical data of 53 cases for POAG treated with simple EX-PRESS shunt implantation(22 cases,34 eyes)as control group and its combination with biological amniotic membrane implantation(31 cases,38 eyes)as experimental group were retrospectively analyzed.Intraocular pressure(IOP)preoperatively and postoperatively were statistically evaluated.Filtering bleb and incidences of postoperative complications were observed in our hospital during the period of January of 2015 to April of 2017.RESULTS:At each time point after the operation,the mean IOP of the experimental group and the control group decreased distinctly respectively,the difference was statistically significant(P<0.05).There was no significant difference on the mean IOP between the experimental group and the control group at 1d and 1wk after operation(P<0.05).The mean IOP in the control group was higher than experimental group at 3 and 6mo(P<0.05).The rate of functional filtration blebs were different between experimental group and control group during at postoperatively 3mo(P<0.05).The complications included shallow anterior chamber,hemorrhage,posterior synechia of the iris,and corneal edema after surgery,and its incidences was not different between two groups(P<0.05).CONCLUSION:EX-PRESS shunt combined with biological amniotic membrane implantation can effectively and safely reduce intraocular pressure,and improve the condition of filtering bleb after operation,and has longterm effect on IOP.