Abstract:AIM:To compare the effects after two different surgical methods on visual field and retinal nerve fiber layer(RNFL)thickness in patients with glaucoma.
METHODS: Clinical data of 69 cases patients(82 eyes )with glaucoma between December 2015 to May 2017 in our hospital for anti-glaucoma surgery were collected. According to operation method, they were divided into EP group(EX-PRESS glaucoma shunt implantation)and XQ group(trabeculectomy). Intraocular pressure, anterior chamber depth(ACD), anterior chamber capacity(ACV), anterior chamber angle width(ACA), optical pupil diameter(PD), visual acuity, visual sensitivity index mean defect(MD), visual correction pattern standard deviation(CPSD), mean sensitivity(MS)and retinal nerve fiber layer thickness(RNFLT)were observed in the preoperative, postoperative 1mo and postoperative 3mo, and the postoperative complications were compared.
RESULTS: Hospitalization time of 3.08±0.42d in the EP group was significantly lower than 4.53±1.28d in the XQ group(t=6.124, P<0.05). The visual recovery time of 3.26±0.30d in the EP group was significantly lower than 4.96±1.36d in the XQ group(t=6.920, P<0.05). The ACA, ACD and ACV after surgery of two groups were significantly higher than those before operation, and the PD after surgery was lower than before operation, and the differences were not statistically significant between two groups after surgery(P>0.05).The postoperative RNFLT, MD and CPSD were all decreased in both groups(P<0.05), and postoperative MS increased(P<0.05); compared with XQ group, the postoperative CPSD after surgery in EP group was significantly reduced(P<0.05).The total incidence of postoperative complications of EP group was 38%, which was significantly lower than 70% in XQ group, the difference was statistically significant(χ2=8.094, P=0.004).
CONCLUSION: Compared with trabeculectomy, EX-PRESS glaucoma shunt implantation is more effective to slow the progress of vision, and it is more conducive to recovery of the patient's vision after surgery with higher security. The improvement of the thickness of the retinal nerve fibers after EX-PRESS glaucoma shunt implantation is consistent with trabeculectomy.
