摘要
目的:探讨玻璃体切割联合青光眼Baerveldt植入物(pars plana vitrectomy and Baerveldt glaucoma implant,PPV-BGI)治疗难治性青光眼的临床疗效。方法:回顾性分析2013-03/2015-12本院收治并实施PPV-BGI的129例132眼难治性青光眼患者的临床治疗资料,其中63眼为新生血管性青光眼(neovascular glaucoma,NVG),69眼为其他类型的青光眼(non-NVG)。分析两组患者的术后眼压(intraocular pressure,IOP)变化、手术结果、视力(visual acuity,VA)、青光眼药物的使用数量、并发症和手术成功率。结果:NVG组患者和non-NVG组患者1a累计成功率分别为46.0%、81.2%,差异有统计学意义(P<0.05)。NVG组患者IOP术后1a从术前40.1±10.4mmHg下降至17.8±4.9mmHg,non-NVG组患者则从30.4±10.2 mmHg下降至14.9±4.1mmHg,术前与术后1a相比,差异有统计学意义(P<0.05)。NVG及non-NVG组患者术前青光眼药物使用数量分别为2.9±1.4和2.7±1.2种,术后1a NVG及non-NVG组患者青光眼药物使用数量分别下降为0.96±1.18和0.51±0.96种,差异有统计学意义(P<0.05)。术后NVG组视力改善患者13例14眼,non-NVG组患者改善37例38眼,差异有统计学意义(P<0.05)。术后1d及术后随访1a结果表明,NVG组患者并发症发生情况明显高于non-NVG组,差异有统计学意义(P<0.05)。结论:PPV-BGI是难治性青光眼手术的一种可行性手术选择,但术后视力恢复效果往往不理想,因为术后往往会有并发症的发生,特别是新生血管性青光眼。
AIM： To investigate the clinical efficacy of pars plana vitrectomy and Baerveldt glaucoma implant（PPV-BGI） in the treatment of refractory glaucoma. METHODS： One hundred twentynine refractory glaucoma patient＇s clinical data from March 2013 to December 2015 that underwent PPV - BGI were retrospectively reviewed. Among them, 63 eyes were neovescular glaucoma （NVG） and 69 eyes were other types of glaucoma （non- NVG ）. The changes of intraocular pressure （ IOP）, surgical results, visual acuity （ VA ）, the number of glaucoma medications, complications, and the success rate of surgery were analyzed.RESULTS： Cumulative success rates for the NVG group and non- NVG group were 46. 0% and 81. 2%, respectively, within l a after surgeries, the difference was significantly （ P〈 0. 05）. Preoperative lOP was 30. 4 ± 10.2mmHg in the non-NVG group and 40.1±10.4mmHg in the NVG group, and lOP was reduced to 14.9±4. lmmHg in the non-NVG group and 17. 8±4. 9mmHg in the NVG, and the difference was significantly （P〈0.05）. Number of glaucoma medications decreased from 2.7 ± 1.2 in the non-NVG group and 2. 9 ± 1. 4 in the NVG group preoperatively to 0.51 ± 0.96 in the non- NVG group and 0.96±1. 18 in the NVG group, and the difference was significantly （P〈0.05）. Improvement in VA of in the NVG group and non-NVG group were observed in 14 eyes of 13 patients and 38 eyes and 37 patients respectively, and the difference was significantly （ P〈 0.05）. The postoperative complications of ld and la follow-up in NVG group was significantly higher than non-NVG group （P〈0.05）. CONCLUSION： PPV-BGI is a viable surgical option for eyes with refractory glaucoma, but visual outcomes are frequently poor because of ocular comorbidities, especially in eyes with NVG.
出处
《国际眼科杂志》
CAS
2017年第11期2093-2096,共4页
International Eye Science
