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[摘要]
目的:探讨Ex-press青光眼引流钉植入术治疗难治性青光眼的临床疗效与安全性。
方法:回顾性分析行Ex-press青光眼引流钉植入术治疗的难治性青光眼患者22例23眼。观察术前及术后1wk,1、2、3、6mo,1a的视力、眼压及并发症发生情况。
结果:所有患者均随访至1a。完全成功率为52%(12眼),部分成功率22%(5眼),总成功率74%。术前平均眼压为40.59±11.11mmHg(1mmHg=0.133kPa),术后1wk,1、2、3、6mo,1a的平均眼压分别为10.30±5.07、12.23±4.03、13.87±4.62、16.52±6.09、18.35±7.06、19.65±8.26mmHg。术后各时间点眼压与术前眼压相比均有统计学意义(P<0.01)。术后患者视力较术前提高,差异有统计学意义(P<0.01)。 23眼中3眼出现少量前房出血,分别于术后4~7d自行吸收; 2眼出现一过性低眼压,密切观察8~10d后眼压>6mmHg; 1眼术后1mo出现渗出性脉络膜脱离,给予局部使用激素后于术后37d复位。所有患者均未出现其他并发症。
结论:Ex-press青光眼引流钉植入术治疗难治性青光眼安全有效。
[Key word]
[Abstract]
AIM: To explore the safety and efficacy of Ex-press glaucoma value implantation for the treatment of refractory glaucoma.
METHODS:The data of 22 patients(23 eyes)with refractory glaucoma received implantation of Ex-press glaucoma value were retrospectively analyzed. The visual acuity, intraocular pressure(IOP)and complications in all patients were observed before and after operation in 1wk, 2mo, 3mo, 6mo and 12mo.
RESULTS:All patients were followed up for 1y. The complete success rate was 52%(12 eyes), the partial success rate was 22%(5 eyes)and the total success rate was 74%. The IOP of preoperative and postoperative 1wk, 1mo, 2mo, 3mo, 6mo, and 12mo was 40.59±11.11, 10.30±5.07, 12.23±4.03, 13.87±4.62, 16.52±6.09, 18.35±7.06 and 19.65±8.26 mmHg,(1mmHg=0.133 KPa)respectively. Postoperative IOP at every time point was significantly decreased compare to preoperation(P<0.01). The visual acuity was significantly improved postoperatively(P<0.01). Postoperative hyphema were found in 3 eyes, transient low IOP in 2 eyes, and choroids detachment in 1 eye. All of these complications appeared at the early postoperative stage and healed within 4-14d. No other complications were observed.
CONCLUSION:Ex-press glaucoma value implantation seemed to be one of the most safe and effective way in treatment of refractory glaucoma.
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