摘要
目的评价非穿透性小梁手术(NPTS)联合非吸收亲水丙烯酸假体(T-Flux)植入术治疗原发性开角型青光眼 (POAG)的中长期疗效及安全性。设计回顾性病例系列。研究对象 POAG患者85例(107眼)。方法对POAG患者行NPTS联合T-Flux植入术治疗,术后随访12-24个月,平均(18．7±5．0)个月。观察视力、眼压、滤过泡、前房深度及术后并发症等。主要指标视力、眼压、杯盘(C／D)比值、滤过泡、前房深度、术中及术后并发症。结果术后1年、1．5年、2年时术眼平均眼压分别为(17．9± 4．2)mmHg、(17．8±4.2)mmHg、(18．9±5．1)mmHg,与术前眼压(31．5±7．8)mmHg相比明显降低(P均<0．001);手术完全成功率分别为 86．9％、83.6％、79．6％;手术部分成功率分别为88．9％、86．5％、81．5％。手术成功与功能型滤过泡的形成和维持有明显关系,而与术中有无小梁网和狄氏膜微穿孔关系不大。并发症包括术中小梁网和狄氏膜穿孔、前房出血,术后早期低眼压、浅前房、脉络膜脱离等。结论 NPTS联合T-Flux植入术治疗POAG疗效显著,并发症少而轻。
Objective To evaluate the efficacy and safety of non-penetrating trabecular surgery （NPTS） with T-Flux implant in primary open-angle glaucoma （POAG）. Design Retrospective case series study. Participants Eighty-five patients （107 eyes） with POAG. Methods 85 primary open-angle glaucoma patients （ 107 eyes） underwent NPTS with T-Flux implant. The average follow-up period was 12 to 24 months （mean follow-up time was 18.7±5.0 months）. The visual acuity, intraocular pressures （IOP）, cup/disc ratio, filtering blebs, and the complications were observed. Main Outcome Measures Visual acuity, intraocular pressures（IOP）, cup/disc ratio, filtering blebs, anterior chamber depth, operative and postoperative complications. Results The preoperative IOP from a mean value of 31.5±7.8mmHg decreased postoperatively to 17.9±4.2mmHg at 1 year, 17.8~4.2mmHg at 1.5 years, and 18.9±5.1mmHg at 2 years （P〈 0.001）. The rate of complete success （IOP≤21mmHg without medication） was 86.9% at 1 year, 83.6% at 1.5 years, and 79.6% at 2 years. The rate of partial success （IOP≤21mmHg with topical medication） was 88.9% at 1 year, 86.5% at 1.5 years, and 81.5% at 2 years. The success rate was significantly depending on formation and retention of the reflective filtering bleb, but not on perforation of the trabeculo-Descemet membrane. The peri-operative complications were perforation of the trabeculo-Descemet membrane and hyphema. The early postoperative complications were ocular hypotony, fiat anterior chamber, and choroidal detachment. Condusion NPTS with T-Flux implant is a safe operation which can provide reasonable control of lOP in POAG.
出处
《眼科》
CAS
2006年第2期97-101,共5页
Ophthalmology in China
