XEN凝胶引流管植入术在青光眼治疗中的应用研究进展

Research progress on the application of XEN gel stent implantation in glaucoma treatment

XEN凝胶引流管植入术是一种新型微创青光眼手术(MIGS),通过一种新型交联材料制成的微型引流管构建房水流出的结膜下外引流新通路。引流管可应用内、外入路2种方法植入,二者各有优劣。目前,XEN凝胶引流管已在多种类型的青光眼及白内障超声乳化联合手术中证实了其长、短期良好的有效性及安全性,并与其他抗青光眼滤过性手术展开对比研究。术后滤过泡相关的并发症常见,针刺分离和开放性滤过泡修复常用于其术后干预。该术式是MIGS的典型代表,具有操作较简单、组织损伤小、手术时间短、降眼压效果良好、安全性好等优点,明显扩大了MIGS适应证的范围,在青光眼治疗中具有良好的临床应用前景。本文就XEN凝胶引流管的材料及其特性、手术操作技巧、适应证及禁忌证、临床应用、并发症等研究进展进行综述。

XEN gel stent implantation,a novel minimally invasive glaucoma surgery(MIGS),constructs a novel subconjunctival external filtration pathway for aqueous humor outflow through a microfilter tube made of an innovative cross-linked material.The implant can be inserted via ab interno and ab externo approaches,each with its advantages and disadvantages.At present,XEN gel stent has demonstrated satisfactory efficacy and safety in both the short and long term in various types of glaucoma and combined phacoemulsification.Comparative studies with other filtering glaucoma surgeries have been conducted.Postoperative bleb-related complications are the most common ones,which are often treated by needling and open bleb revision.This procedure is a typical representative of MIGS,which offers the advantages of easy operation,less invasive,shorter operation time,valid intraocular pressure reduction,fewer complications and high safety,therefore significantly expanding the range of indications for MIGS and offering a favorable application prospect for clinical treatment of glaucoma.This article reviews the research progress of the material and characteristics,surgical techniques,indications and contraindications,clinical applications and complications of XEN gel stent.