目的：探究使用显微玻璃体视网膜(MVR)刀行90°鼻下节段性前房角切开术治疗轻中度原发性开角型青光眼(POAG)及假性剥脱性青光眼(PEXG)患者的疗效及安全性。

方法：回顾性纳入2021年6月至2023年1月接受单纯前房角切开术或前房角切开术联合超声乳化白内障吸除术的患者60例60眼，其中，45眼行前房角切开术联合超声乳化白内障吸除术，15眼行单纯前房角切开术。收集患者术后1、3、6、12 mo眼压(IOP)及用药次数，并记录患者术后1 d、1 wk、1、3、6、12 mo不良反应。主要指标为IOP较术前降低20%且术后1 a抗青光眼药物使用次数减少，次要指标为手术成功率，即术后1 a IOP<18 mmHg(不限抗青光眼药物使用与否)。

结果：术后1 a，78%患者IOP及用药次数降低20%，63%患者手术成功。最常见的并发症为微前房积血，均未出现需要手术干预的并发症。

结论：MVR刀行节段性鼻下前房角切开术可显著降低POAG及PEXG患者IOP及用药次数，且术后1 a显著减少或延缓需行青光眼滤过术的患者。

METHODS: This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023, and 45 eyes underwent goniotomy combined with phacoemulsification, and 15 eyes underwent goniotomy as a stand-alone procedure. Postoperatively, intraocular pressure(IOP)and the number of medications were collected at 1, 3, 6, and 12 mo. The side effects of surgery were recorded 1 d, 1 wk, and 1, 3, 6, and 12 mo postoperatively. The primary outcomes were a reduction in IOP of at least 20% from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively. The secondary outcome was surgical success, defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.

RESULTS: At the end of 1 a, 78% of patients achieved both a >20% reduction in IOP and a reduction in the number of medications used. Overall success was achieved in 63% of patients. Microhyphaema was the most common complication, none of the patients experienced a complication requiring surgical intervention.

CONCLUSION: Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG, and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.