深层巩膜切除术联合透明质酸片植入治疗原发性开角型青光眼(英文)

Deep sclerectomy with hyaluronate implant for primary open-angle glaucoma

目的:探讨深层巩膜切除联合透明质酸片植入(DSHI)治疗原发性开角型青光眼(POAG)的临床疗效。方法:回顾性总结在Saarland大学眼科医院行DSHI治疗的POAG。结果:符合条件并入选的有216患者的377只POAG。平均随诊31(5～51)mo。术前平均眼压(28.3±8.4)mmHg(1mmHg=0.133kPa),术后1wk,6mo,1、2、3、4a眼压分别为(9.7±3.6)、(12.4±5.3)、(15.5±8.7)、(15.4±6.8)、(16.1±6.7)、(17.4±7.5)mmHg。术前平均视力为0.65,术后1wk,6mo,1、2、3、4a视力分别为0.63、0.68、0.72、0.71、0.76、0.70。术后1a显效(不加抗青光眼药物且眼压≤21mmHg)率为89%,有效(加抗青光眼药物时眼压≤21mmHg)率为9%。术后4a时,显效率为45%,有效率48%。并发症包括切口渗漏、前房出血、脉络膜脱离等。结论:DSHI对POAG治疗效果良好,并发症少且轻微。

AIM: To explore the clinical effects of deep sclerectomy with hyaluronate implant (DSHI) for primary open-angle glaucoma (POAG).· METHODS: A retrospective investigation was made in patients with POAG treated with DSHI in Saarland University.· RESULTS: A tolal of 377 eyes in 216 patients with POAG were selected. The average follow-up was 31 months(5-51 months). The mean intraocular pressure (IOP) was 28.3±8.4 mmHg (1mmHg=0.133kPa) before surgery, and 9.7±3.6, 12.4±5.3, 15.5±8.7, 15.4±6.8, 16.1±6.7 and 17.4±7.5 mmHg respectively at 1 week, 6 months, 1 year, 2 years, 3 years and 4 years after surgery. The mean visual acuity was 0.65 before surgery, and 0.63, 0.68, 0.72, 0.71, 0.76, 0.70 respectively at 1 week, 6 months, 1 year, 2 years, 3 years and 4 years after surgery. Complete success rate (IOP≤21 mmHg without antiglaucoma medication) was 89% and qualified success rate (IOP≤21mmHg with antiglaucoma medication) was 9% at 1 year after surgery. They were 45% and 48% at 4 years after surgery respectively. Complications included wound leak, hyphema and choroidal detachment, etc.· CONCLUSION: DSHI is efficacious for POAG. Complications following DSHI were rare and mild.·