Efficacy and safety of Usights UC100 illuminated microcatheter in microcatheter-assisted trabeculotomy

AIM:To evaluate the efficacy and safety of Usights UC100 illuminated microcatheter in microcatheter-assisted trabeculotomy(MAT).METHODS:Totally 10 eyes of 10 patients with primary open angle glaucoma(POAG)who underwent MAT facilitated by Usights UC100(5 eyes)or iTrack(5 eyes)were reviewed.The success of this surgery was defined as intraocular pressure(IOP)<22 mm Hg with>30%reduction,without oral glaucoma medications,or additional glaucoma surgery.RESULTS:The mean pre-operative IOP was 25.38±10.22 mm Hg in the Usights UC100 group and 19.98±3.87 mm Hg in the iTrack group.MAT was achieved in all eyes in both groups.The success rates for the Usights UC100 group and iTrack groups were in all and 4 eyes,respectively.Both microcatheters produced a statistically significant reduction in IOP,and eyes using Usights UC100 achieved a lower IOP than the iTrack group at 3mo followup(12.58±1.52 and 14.84±1.89 mm Hg,respectively),but no statistical significance was there.No severe side effects were observed in either group.CONCLUSION:MAT using Usights UC100 or iTrack both achieve significant pressure reduction in cases of POAG,and Usights UC100 is as safe as iTrack.

Efficacy of microcatheter-assisted trabeculotomy on secondary glaucoma after congenital cataract surgery

AIM: To evaluate efficacy of microcatheter-assisted trabeculotomy(MAT) in eyes with secondary glaucoma after congenital cataract surgery and explore its correlation with the different degree of trabeculotomy. METHODS: A retrospective analysis was conducted on patients who underwent the said procedure between September 2019 and September 2020. The patients were classified into two groups according to the degree of trabeculotomy(group 1: ≤240-degree;group 2: 240–360-degree). The intraocular pressure(IOP) and antiglaucoma drugs before and after operation was collected during the 12-month follow-up. RESULTS: Totally 27 eyes of 25 patients were included: 11(40.7%) eyes in group 1 and 16(59.3%) eyes in group 2. The mean IOP of all patients was 34.67±9.18 mm Hg preoperatively and 8.74±4.32, 9.95±5.65, 14.39±5.30, 16.02±4.37, 15.82±3.28, and 16.19±3.56 mm Hg 1 d, 1 wk, 1, 3, 6, and 12 mo after surgery, respectively. In all patients, there were significant differences in IOP at each time point(F=65.614, P<0.01). In each group, IOP after surgery was lower than that before surgery(all P<0.01), but there was no difference in the rate of IOP reduction between the two groups(P=0.246). Furthermore, the amount of anti-glaucoma medications reduced to 0.30±0.67(0–2) at 12 mo from 2.63±0.49(2–3) preoperatively(P<0.01), and there was no difference between the two groups(P>0.05). At the end of follow-up, the partial success rate was 81.8% in group 1 vs 93.75% in group 2(P=0.549). Various amount of intraoperative and postoperative hyphema occurred in all eyes, which spontaneously absorbed or cleaned through paracentesis and irrigation. No other serious complications was observed.CONCLUSION: MAT can effectively reduce IOP in patients with secondary glaucoma after congenital cataract surgery with a high success rate and safety. And it can be used as the first choice for the treatment of secondary glaucoma after surgery for congenital cataracts.

Clinical significance of episcleral venous fluid wave in gonioscopy-assisted transluminal trabeculotomy

AIM:To evaluate the clinical significance of checking episcleral venous fluid wave(EVFW)during gonioscopyassisted transluminal trabeculotomy(GATT)in patients with open angle glaucoma(OAG).METHODS:This retrospective case series study comprised 30 patients(45 eyes)with OAG underwent GATT.The location and extent of EVFW were examined and graded after intraoperative compression flushing of the anterior chamber angle during the operation.Patients were followed up for 1y.A complete success for surgery is defined as a postoperative intraocular pressure(IOP)<18 mm Hg without any anti-glaucoma medication.IOP<18 mm Hg with less than two anti-glaucoma medications is defined as qualified success,while the control of IOP requiring three anti-glaucoma medications is considered as unsuccess.RESULTS:The mean IOP was 35.38±7.16 mm Hg before surgery and 15.52±4.22 mm Hg 1y after surgery(P<0.01).The average number of anti-glaucoma medication was 2.8±1.2(2-4)preoperation and 0.6±1.3(0-3)1y postoperation(P<0.01).The success rate of the operation was 93.33%.Complete success rate was 66.67%,qualified success rate was 26.67%,and 6.66%of unsuccessful cases required reoperation.EVFW of all cases was grade 2-4,and the percentages of grade 2,3 and 4 were 33.33%,40.0%and 26.67%,respectively.The distribution and percentage of EVFW were inferior(36%),nasal(28%),superior(20%),and temporal(16%).The EVFW grade of complete success patients was 3.4±0.6(3-4),and that of qualified success patients was 2.6±1.0(2-4).The larger the range of EVFW,the lower the IOP,and the better the IOP reduction effect.CONCLUSION:During GATT surgery,pressurized irrigation of anterior chamber to check EVFW can reduce the outflow resistance of aqueous humor and increase the effect of postoperative IOP.The range of EVFW is negatively correlated with postoperative IOP.Therefore,EVFW may be a valuable prognostic indicator for the success of GATT surgery.

One-year outcomes and predictable factors for microhook ab interno trabeculotomy

AIM: To investigate the one-year outcomes and factors that influence the results of microhook ab interno trabeculotomy(μLOT). METHODS: The medical records of consecutive patients with open angle glaucoma who underwent μLOT(including combination of μLOT and cataract surgery) between Februar y 2018 and July 2019 were retrospectively reviewed. Surgical success was defined as the following: an intraocular pressure(IOP)≤21 mm Hg or IOP≤preoperative IOP with a reduced number of glaucoma eye drops, without additional glaucoma surgery, and assessed using KaplanMeier survival analysis. A multivariate Cox proportionalhazards regression model was used to investigate the factors associated with surgical failure.RESULTS: The 59 eyes of 59 patients comprising 28 eyes with primary open angle glaucoma(POAG) and 31 with secondary open angle glaucoma(SOAG) were included. The mean IOP and number of glaucoma eye drops significantly decreased from 25.3±7.2 mm Hg and 3.9±1.1, preoperatively to 16.1±4.4 mm Hg(P<0.01) and 2.1±1.8(P<0.01),respectively, 12 mo postoperatively, with a cumulative success rate of 63.1%. The one-year success rate was significantly higher in POAG eyes than in SOAG eyes(80.0% vs 48.0%;P=0.011, log-rank test). Multivariate analyses revealed SOAG [P=0.017, adjusted hazard ratio(a HR): 3.468, 95%CI: 1.246-9.654] and the postoperative IOP spike(IOP>25 mm Hg within 2 wk post-surgery;P<0.001, a HR: 5.382, 95%CI:2.113-13.707) as independent factors associated with surgical failure.CONCLUSION: The μLOT is a good treatment option for POAG eyes. However, the postoperative course should be carefully followed in cases with postoperative IOP spike.

Systematic review and Meta-analysis of treating open angle glaucoma with gonioscopy-assisted transluminal trabeculotomy

●AIM:To systematically review and Meta-analyze studies of managing open angle glaucoma(OAG)with gonioscopyassisted transluminal trabeculotomy(GATT)and to evaluate its effectiveness and safety.●METHODS:Eligible studies were retrieved and screened from five main electronic databases.Mean difference(MD)was hired to show the pooled effectiveness of intraocular pressure(IOP)and medication decrease achieved by GATT.In addition,combined surgical success and reoperation rates were calculated,and complications were also summarized.●RESULTS:Ten studies were included for systematic review,but one study was not pooled for Meta-analysis due to the repeated data.The combined IOP decrease after GATT was 9.81 mm Hg(95%CI:7.98-11.63 mm Hg)which showed significant reduction from the baselines(Z=10.52,P<0.0001).Similarly,the number of medications after GATT also decreased distinctly compared with that of medication before the surgery(Z=9.09,P<0.0001),and the pooled medication decrease was 1.68(95%CI:1.31-2.04).In addition,the combined surgical success rate was 85%,while the pooled reoperation rate was 20%.Sightthreatening complications occurred scarcely,whereas the pooled occurrence rate of hyphemia was as high as 36.0%.●CONCLUSION:GATT could effectively lower IOP and decrease medications for patients with OAG.Moreover,the procedure appears to be a safe and promising treatment for OAG due to its minimally-invasive and conjunctiva-sparing nature.

Comparison of minimally invasive glaucoma surgery with trabecular micro-bypass stent and microhook ab interno trabeculotomy performed in conjunction with cataract surgery

AIM: To evaluate the effectuality and safety of cataract surgery combined with either ab interno trabeculotomy by the microhook(μLOT) or a single i Stent? trabecular bypass implantation(i Stent) in eyes with cataract and mild-tomoderate glaucoma. METHODS: This study enrolled subjects with mild-tomoderate open angle glaucoma with visually significant cataract who used two or more ophthalmic antiglaucoma agents between 60 and 90 y of age. Patients underwent cataract surgery cooperated with either implantation of an i Stent(i Stent-phaco) or excisional goniotomy with the μLOT(μLOT-phaco). Patients underwent μLOT-phaco in the eye with lower the mean deviation, according to the Humphrey field analyzer, while i Stent-phaco was carried out on the other eye. Intraocular pressure(IOP) pre-and post-surgery, alterations in anterior chamber flare(ACF), and corneal endothelial cell density(ECD) were estimated.RESULTS: Twenty subjects were enrolled(mean age: 73.6±7.3 y). The mean medicated preoperative IOP was 16.7 mm Hg in the μLOT and 16.2 mm Hg in the i Stent eyes. The mean final IOP at 12 mo was 13.6 mm Hg in the μLOT eyes and 13.6 mm Hg in the i Stent eyes, representing a 17.8% and 17.2% reduction, respectively. The preoperative ACF in the μLOT eyes was 9.5 pc/ms and it returned to normal in 30 d postoperatively, with a value of 11.4 pc/ms. In the i Stent eyes, ACF was 9.6 pc/ms preoperatively and it returned to normal by 7 d postoperatively(11.2 pc/ms atday 7), demonstrating that postoperative inflammation was less in the i Stent eyes. The corneal ECD in both groups was not significantly decreased.CONCLUSION: In this study, i Stent and μLOT are both effective through 12 mo of follow-up. Safety is more favorable in the i Stent eyes, based on early anterior chamber inflammation.

Full-thickness scleral incisions technique for the treatment of a cyclodialysis cleft following ab interno trabeculotomy

Dear Editor, I am Dr.Daniela Alvarez-AscenciofromtheGlaucoma Department at Asociacion Para Evitar la Ceguera (APEC)in Mexico City, Mexico. I write to present a successful case of cyclodyalisis repair in a direct visualization technique that was performed on a patient after a microincisional glaucoma surgery (MIGS) complication.

Therapeutic effect analysis on the treatment of congenital glaucoma through modified combined trabeculotomy-trabeculectomy

AIM： To evaluate the therapeutic effect and the safety of the treatment of congenital glaucoma through modified combined trabeculotomy-trabeculectomy. METHODS： The clinical data of 27 cases （altogether 42 eyes）, which included 7 cases of infants （10 eyes） and 20 cases of teenagers （32 eyes）, of congenital glaucoma undertook modified combined trabeculotomy trabeculectomy were analyzed retrospectively. The parameters evaluated included the post operation visual acuity, the anterior chamber, the filtering bleb, the intraocular pressure, the C/D ratio, visual field, the retinal nerve fiber layer changes and the complications. RESULTS： The follow-up period was 1 to 29mo, averaging 13.3 ±7.7mo. Upon the last visit after the operation, functional filtering blebs developed in all the involved eyes. The intraocular pressure was controlled under 21 mm Hg, which was decreased by 60% when compared with that before the operation, without using any medication. There were no significant changes in the post operation visual acuity and the retinal nerve fiber layer thickness before and after the operation in teenager group （P〉0.05）, and both the post operation C/D ratio and the visual field mean defect （MD） were reduced compared with those before the operation （P〈0.05）. There were no severe complications in any of the patients. CONCLUSION： The modified combined trabeculotomy- trabeculectomy can effectively reduce the intraocular pressure and control the development of glaucoma in cases of congenital glaucoma. It is a safe and effective operative method for the treatment of congenital glaucoma

Surgical Outcomes of Trabeculotomy in Newborns with Primary Congenital Glaucoma

Background： Early surgical intervention is required for the primary congenital glaucoma （PCG）. There are currently few reports on the surgical outcomes in infants with PCG. This study aimed to evaluate the efficacy and safety oftrabeculotomy and the postoperative visual outcomes in Chinese newborns with PCG within 4 weeks of birth. Methods： A total of 21 eyes of 12 patients with PCG who underwent primary trabeculotomy within 4 weeks of birth were retrospectively studied. Preoperative and postoperative intraocular pressure （lOP）, corneal clarity and diameter, axial length and optic disc cupping, visual acuity and postoperative refractive error, success rates, and complications were evaluated. Kaplan-Meier survival analysis was applied to evaluate the success rates. Results： The mean follow-up time was 46.9 ~ 34.4 months （range： 12-122 months）. The postoperative lOP was significantly lower than the preoperative lOP at all of the follow-up visits （P 〈 0.001 ）. The complete success rates for all eyes at 1,2, 3, and 5 years postoperatively were 90.5%, 85.7%, 85.7%, and 85.7%, respectively. The lOPs of the three patients who needed antiglaucomatous medications postoperatively were also well controlled. At the last visit, the cornea became clear, and the cup-to-disc ratio decreased significantly （P = 0.01） although the horizontal corneal diameter did not change significantly （P = 0.11 ）. Visual acuities were able to be recorded in eight eyes at the last visit, among which six eyes had a best-corrected visual acuity of 20/40 or better. There were no severe intraoperative or postoperative complications. Conclusions： Trabeculotomy proves to be a safe and effective treatment in reducing lOP in this group of Chinese newborns with PCG. The outcomes of vision function were satisfactory in most of the patients.

Modified trabeculotomy for primary congenital glaucoma

In traditional trabeculotomy,a radial incision is performed at the corneoscleral transition zone to locate the Schlemm＇s canal.However,in some conditions,finding the Schlemm＇s canal is difficult because of the enlargement of the comea,developmental anomalies of the angle,etc.In our study,we performed a modified trabeculotomy,to locate the Schlemm＇s canal easily and accurately and evaluated the outcomes.

微导管辅助全周小梁切开术对PPV术后继发性青光眼的疗效及安全性评估

目的观察微导管辅助全周小梁切开术治疗玻璃体切割术(PPV)后继发性青光眼的有效性及安全性。方法采用系列病例观察研究方法,纳入2016年5月至2022年2月在河南省立眼科医院和北京同仁医院接受PPV且术后继发青光眼患者17例17眼,其中接受PPV的原发病包括视网膜脱离13眼,玻璃体积血3眼,眼内炎1眼。所有患者均行激光微导管辅助全周小梁切开术,包括房角镜下内路小梁切开术6眼、经巩膜瓣途径微导管引导下外路小梁切开术11眼。微导管辅助全周小梁切开范围均≥300°,其中360°者11眼,330°者4眼,300°者2眼。分别于术前、术后1周、1个月、6个月、12个月采用Goldmann眼压计测量眼压;采用标准视力表测定最佳矫正视力(BCVA)并转换为LogMAR视力;记录术后用药数量变化及并发症发生情况。评估的主要结局指标为眼压和手术成功率,次要结局指标为术后用药数量、BCVA变化和并发症。手术成功定义为术后使用或不使用降眼压药物的情况下眼压<21 mmHg(1 mmHg=0.133 kPa)。结果患者术前及术后1周、1个月、6个月和12个月平均眼压分别为(34.41±5.11)、(21.88±11.72)、(20.77±7.67)、(19.50±7.01)、(16.32±4.68)mmHg,总体比较差异有统计学意义(F=20.779,P<0.001),其中术后各时间点眼压均低于术前,差异均有统计学意义(均P<0.01)。术后12个月,14眼眼压较术前降低40%以上。术后6、12个月手术成功率均为76.5%。术后降眼压药物使用数量较术前明显减少,差异有统计学意义(Z=-4.580,P<0.001)。术后6个月,术眼BCVA与术前比较差异无统计学意义(Z=-1.311,P=0.190)。术眼术后均未见严重并发症发生。结论微导管辅助全周小梁切开治疗PPV术后继发青光眼具有较好的疗效和安全性。

外路全周缝线小梁切开术对原发性开角型青光眼患者24h眼压波动规律的影响

目的:评估外路全周缝线小梁切开术(CST)对原发性开角型青光眼(POAG)24 h眼压波动规律的影响。方法:回顾性研究。纳入2021-03/2022-05在我院就诊的药物治疗眼压控制不佳的POAG患者18例18眼,均行CST治疗,分别在术前,术后1 a进行24 h眼压检查(选择时间点为9∶00 AM、12∶00 AM、3∶00 PM、6∶00 PM、9∶00 PM、12∶00 PM、3∶00 AM、6∶00 AM),比较术前,术后1 a 24 h眼压均值、峰值及峰值时间、谷值及谷值时间、波动范围及昼夜平均眼压差变化。结果:术前,术后1 a 24 h眼压曲线均呈现日间下降、夜间升高的变化趋势,下午降至波谷,夜间升至波峰;与术前相比,术后1 a 24 h眼压谷值、峰值时间较术前提前,术后1 a 24 h眼压均值、峰值、谷值明显下降,波动范围无明显差异,昼夜平均眼压差明显增加。结论:CST可降低POAG患者眼压,但不改变24 h眼压波动范围,反而升高昼夜平均眼压差,提示CST不能改善POAG患者昼夜眼压波动。

Cost analysis of childhood glaucoma surgeries using the US Medicaire allowable costs

AIM: To analyze and calculate the relative cost of various childhood glaucoma surgical interventions per mm Hg intraocular pressure(IOP) reduction($/mm Hg).METHODS: Representative index studies were reviewed to quantitate the reduction of mean IOP and glaucoma medications for each surgical intervention in childhood glaucoma. A US perspective was adopted, using Medicare allowable costs to calculate cost/mm Hg IOP reduction($/mm Hg) at 1y postoperatively.RESULTS: At 1y postoperatively, the cost/mm Hg IOP reduction was $226/mm Hg for microcatheter-assisted circumferential trabeculotomy, $284/mm Hg for cyclophotocoagulation, $288/mm Hg for conventional ab-externo trabeculotomy, $338/mm Hg for Ahmed glaucoma valve, $350/mm Hg for Baerveldt glaucoma implant, $351/mm Hg for goniotomy, and $400/mm Hg for trabeculectomy.CONCLUSION: Microcatheter-assisted circumferential trabeculotomy is the most cost-efficient surgical method to lower IOP in childhood glaucoma, while trabeculectomy is the least cost-efficient surgical method.

房角镜辅助下内路360°小梁切开术治疗玻璃体切除术后继发性高眼压

目的:探讨房角镜辅助下内路360°小梁切开术(GATT)治疗玻璃体切除术后继发性高眼压的临床疗效。方法:回顾性研究。纳入2019-01/2022-05在成都市第一人民医院眼科行GATT治疗的玻璃体切除术后继发性高眼压患者10例15眼。记录术前,术后1d,1wk,1、3、6mo最佳矫正视力(BCVA)、眼压、使用的降眼压药物数量及术中、术后并发症,并分析手术成功率。结果:术前和术后6mo时BCVA比较无差异(Z=0,P=1)。术后1d,1wk,1、3、6mo平均眼压17.47±3.78、18.8±3.29、19.13±3.62、20.31±3.66、18.03±3.23mmHg较术前(28.33±9.48mmHg)降低(均P<0.05);术后6mo平均用药1(0,2)种,较术前[2(2,4)种]显著下降(P<0.001);术后1d,1wk,1、3、6mo手术总成功率分别为87%(13眼)、93%(14眼)、87%(13眼)、73%(11眼)、93%(14眼);术后主要并发症为短暂性前房积血(10眼,67%),一过性眼压升高(5眼,33%),未发生其他严重影响视力的并发症。结论:GATT治疗玻璃体切除术后继发性高眼压安全有效。

微创青光眼手术在儿童青光眼治疗中的应用现状和展望

儿童青光眼是一类难治性青光眼,微创青光眼手术(MIGS)为儿童青光眼提供了安全有效的治疗选择。多数已发表的研究倾向于支持应用全周内路小梁切开术,其治疗儿童青光眼的安全性和有效性与非MIGS的全周外路小梁切开术相似。关于KDB刀、小梁消融术和Xen凝胶支架的研究较为有限,但在某些特定的病例中可能有其各自的优势。每一种MIGS手术在考虑其优势之处的同时须特别权衡每种手术方法的长期效果。此外,还需要更多的前瞻性和比较性研究、更大的样本量和更长的随访时间来验证MIGS手术治疗儿童青光眼的安全性和有效性。

全周小梁切开术治疗发育性青光眼

目的评评估微导管引导下全周小梁、Schlemm管切开术治疗发育性青光眼的临床疗效。方法回顾2014年6月至2018年6月郑州市第二人民医院收治的发育性青光眼患儿21例(37眼),行微导管引导下全周小梁、Schlemm管切开术。对患儿手术前后眼压、角膜横径、杯盘比、降眼压药物使用情况及术后并发症进行分析。结果患儿眼压术前术后对比差异有统计学意义(t=17.91,16.25,15.92,15.87,15.58,13.49;P<0.05),64.86%患儿角膜横径、51.35%患儿杯盘比术后较术前减小,术后用药种类显著减少。术中患儿均出现少量前房出血,术后1~3d吸收。术后少量患儿出现虹膜点状黏连、脉络膜脱离,用药后均痊愈。结论微导管引导下全周小梁、Schlemm管切开术是有效治疗发育性青光眼的手术方式,而且术后没有滤过泡,护理简便,无需常年行眼球按摩。

房角镜辅助的内路360°小梁切开术治疗青光眼研究进展

房角镜辅助的内路360°小梁切开术(gonioscopy-assisted transluminal trabeculotomy,GATT)是近年来国内外开展的新型微创青光眼手术,是一种改良的小梁切开术。GATT将微导管(iTrack)环穿Schlemm’s管后,利用微导管张力全周切开小梁网及Schlemm’s管内壁,重建生理性房水流出通道,避免小梁网阻力,实现房水从前房直接进入集液管,通过增加房水流出机制降低眼压。GATT适应证广泛,主要应用于开角型青光眼,包括原发性开角型青光眼和继发性开角型青光眼,同时可运用于闭角型青光眼。GATT微创且不依赖滤过泡,能明显减少降眼压药物的使用,中远期疗效稳定,安全性高,较少发生威胁视力的并发症,可作为开角型青光眼的首选手术方式。该文对GATT在青光眼中的应用、手术步骤、作用机制、有效性、并发症及影响疗效的因素等进行综述,为其临床应用提供参考。

外路小梁切开联合小梁切除术治疗先天性青光眼

目的:评价外路小梁切开联合小梁切除术治疗先天性青光眼的疗效。方法:应用外路小梁切开联合小梁切除术治疗先天性青光眼7例(14眼)。结果:术后7d,14眼眼压降至正常。术后随访平均18mo,13眼眼压控制正常,手术成功率92%,术中常见并发症为少量前房出血,一般在术后1～4d完全吸收,对手术效果无影响。结论:外路小梁切开联合小梁切除术治疗先天性青光眼安全有效。

非穿透性小梁切除术联合小梁切开术治疗先天性婴幼儿型青光眼(英文)

目的:探讨非穿透性小梁切除术联合90度小梁切开术(non-penetrating trabeculectomyc ombined with 90 degrees trabeculotomy,NPTST)对治疗先天性婴儿型青光眼的手术方法及治疗效果,提高临床治疗效率。方法:回顾性分析2010-01/2012-01我院15例30眼原发性婴幼儿型青光眼的患者行NPTST。并分析术后眼压(intraocular pressure,IOP)改变,角膜横径以及并发症的情况。结果:本组术后1wk;1,3,6,12moIOP控制较术前下降,角膜横径保持原来大小或稍有减小,术后并发症发生率低。结论:NPTST对治疗先天性婴幼儿型青光眼成功率高,并发症少,是一种安全有效的治疗术式。

小梁切开联合小梁切除术治疗开角型青光眼

目的:观察小梁切开联合小梁切除治疗开角型青光眼的临床疗效。方法:对10例(16眼)开角型青光眼患者施行外路小梁切开联合小梁切除术。术后观察视力、前房反应、眼压及滤过泡情况。随诊时间1～36个月,平均13.4个月。结果:术后视力3眼无变化,其余均超过术前水平;术后1周眼压为0.93～2.67kPa,平均(1.92±0.67)kPa,末次回访眼压为1.33～2.67kPa,平均(2.05±0.53)kPa。与术前用药后眼压(4.67～4.93kPa,平均5.88kPa)相比下降3.69kPa。结论:小梁切开联合小梁切除治疗开角型青光眼的降眼压效果安全可靠,适用于小梁组织病变或发育异常的宽房角青光眼。