外路微导管辅助的小梁切开术治疗中晚期原发性先天性青光眼

Treatment of ab-externo microcatheter-assisted trabeculotomy in moderate and advanced primary congenital glaucoma

目的:评估外路微导管辅助的小梁切开术治疗中晚期原发性先天性青光眼的疗效。方法:回顾性研究。纳入2018-08/2019-11在西安市第四医院收治的行外路微导管辅助的小梁切开术治疗中晚期原发性先天性青光眼患儿20例22眼。随访12mo,观察手术前后眼压、使用降眼压药物数量、角膜直径、视神经杯盘比、并发症。结果:平均眼压术前为33.4±9.1mmHg,末次随访时为14.4±5.2mmHg(P<0.001),术前使用降眼压药物为2(2,4)种,术后12mo为0(0,2)种(P<0.001)。角膜直径术前为13.34±0.89mm,术后12mo为13.27±0.78mm(P>0.05)。术前视神经杯盘比为0.85±0.17,术后12mo为0.84±0.16(P>0.05)。所有患者均未发生严重手术并发症。结论:外路微导管辅助的小梁切开术治疗中晚期原发性先天性青光眼安全有效。

AIM:To evaluate the effectiveness of ab-externo microcatheter-assisted trabeculotomy(MAT)in moderate and advanced primary congenital glaucoma(PCG).METHODS:A retrospective study.A total of 20 children(22 eyes)with PCG who were admitted to Xi’an Fourth Hospital from August 2018 to November 2019 underwent ab-externo MAT.The follow-up is 12 mo.The intraocular pressure(IOP),numbers of IOP-lowering drugs,corneal diameter,the cup/disk ratio(C/D ratio)of optic nerve and postoperative complications were observed.RESULTS:The mean preoperative IOP was 33.4±9.1 mmHg,while it was 14.4±5.2 mmHg at the last follow-up(P<0.001).The median of IOP-lowering drugs used before surgery was 2(2,4),and it was 0(0,2)at 12 mo after surgery(P<0.001).The preoperative corneal diameter was 13.34±0.89 mm,and it was 13.27±0.78 mm at 12 mo after surgery(P>0.05).The preoperative C/D ratio of optic nerve was 0.85±0.17,and it was 0.84±0.16 at 12 mo after surgery(P>0.05).There were no severe complications occurred in all patients.CONCLUSION:Ab-externo MAT is effective and safe in the treatment of moderate and advanced PCG.