Ex-PRESS引流器与Ahmed引流阀植入术治疗新生血管性青光眼的疗效比较

Comparison of Ex-PRESS drainage implantation and Ahmed valve implantation in the treatment of neovascular glaucoma

目的比较Ex-PRESS引流器与Ahmed引流阀植入术治疗新生血管性青光眼的临床疗效。方法本研究为前瞻性研究。选择于我院就诊的新生血管性青光眼患者23例(23只眼),所有患眼均接受玻璃体腔注射雷珠单抗(lucentis)0.05 ml,于注药1周后随机分为试验组11例(11只眼)采取Ex-PRESS引流器植入术;对照组12例(12只眼)采取Ahmed引流阀植入术。分别于术后1 d、1周、1月、3月、6月记录两组的平均眼压、手术时间、并发症情况,并进行两组间比较。结果两组引流装置植入术后1 d、1周、1月、3月、6月平均眼压均较术前降低,但两组间相比术后差异无统计学意义。Ex-PRESS组和Ahmed组的手术时间分别为(21.5±2.1)min和(44.8±2.3)min,两组间差异有统计学意义(P<0.001)。Ex-PRESS组和Ahmed组总并发症发生率分别为63.6%和33.3%。结论Ex-PRESS引流器与Ahmed引流阀植入术具有相当的降眼压效果。Ex-PRESS引流器植入术的手术操作时间短,Ahmed引流阀植入术操作时间略长,但适应证更广,术后并发症更少,安全性更高。

To compare the outcome of the Ex-PRESS drainage implantation and Ahmed valve implantation for neovascular glaucoma.Methods A prospective study,23 cases(23 eyes)neovascular glaucoma patients in the study,all the cases were injected ranibizumab(Lucentis)0.05ml one week ago,11 cases(11 eyes)were randomly divided into group which were treated by Ex-PRESS drainage implantation,the other 12 cases(12 eyes)were treated by Ahmed valve implantation.All of the eyes were measured the visual acuities,intraocular pressure,operation time,and complications at pre-operation,1 day,1 week,and 1 month,3 and 6 months after surgery.Results In two groups,the average IOPs at 1 day,1 week,1 month,3 and 6 months after surgery were obviously lower that before operation.In Ex-PRESS group and Ahmed group,the postoperative average intraocular pressures were not significant different.In Ex-PRESS group and Ahmed group,the operation time was(21.5±2.1)min,(44.8±2.3)min,respectively.there was statistically significant differences between the two groups(P<0.001).In Ex-PRESS group and Ahmed group,total complication rates were 63.6%and 33.3%,respectively.Conclusions The Ex-PRESS drainage implantation and Ahmed valve implantation provide similar effective IOP control for neovascular glaucoma patients.The Ex-PRESS drainage implantation has shorter operation time,but Ahmed valve implantation has a wide range of indications and lower rates of post-complications.