摘要
目的比较房角镜辅助的360°Schlemm’s管切开术(gonioscopy assisted transluminal trabeculotomy,GATT)与外路微导管引导的小梁切开术(microcatheter assisted trabeculotomy,MAT)对原发性开角型青光眼(POAG)患者角膜生物力学和视力的影响。方法回顾性分析2020年8月至2022年8月郑州大学第一附属医院收治的POAG患者90例(90眼)的临床资料,其中行GATT治疗的患者56例(56眼),行MAT治疗的患者34例(34眼),所有手术由同一术者完成。根据性别、年龄等因素进行倾向性得分匹配,GATT组和MAT组各30例(30眼)入组,比较两组基线资料、手术成功率和术前、术后1周、1个月、3个月的眼压、抗青光眼药物使用数量、角膜生物力学参数[第一压平时间(A1T)、第二压平时间(A2T)、最大压陷时间(HCT)、最大形变幅度(DA)、最大压陷屈膝峰间距(PD)]、视力和并发症发生情况。结果术后1周、1个月及3个月两组眼压均较术前降低,抗青光眼药物使用数量、A1T均较术前下降,A2T、DA、PD、视力较术前升高,差异均有统计学意义(均P<0.05)。术后1周、1个月及3个月,GATT组和MAT组眼压、抗青光眼药物使用数量、A1T、A2T、DA、PD、视力组间比较,差异均无统计学意义(t=0.384、0.318、1.187;0.289、1.933、0.687;0.610、0.197、0.279;0.062、0.856、0.046;0.369、0.899、0.125;0.310、0.619、0.643;0.264、0.089、0.273;0.701、1.879、1.519;P=0.703、0.751、0.066;0.774、0.058、0.495;0.544、0.844、0.782;0.951、0.396、0.963;0.714、0.373、0.901;0.758、0.538、0.523;0.793、0.929、0.786;0.486、0.065、0.134)。GATT组和MAT组完全成功率和条件成功率组间比较,差异均无统计学意义(χ^(2)=0.739、1.456,P=0.390、0.228)。GATT组和MAT组术后均有出血,两组术后睫状体脱离、浅前房发生率组间比较,差异均无统计学意义(χ^(2)=0.317、1.107,P=0.573、0.313)。结论GATT和MAT治疗POAG的疗效相当,可作为POAG患者的有效手术选择。
Objective To compare the effects of atrial angle lens-assisted internal 360°gonioscopy assisted transluminal trabeculotomy(GATT)with external microcatheter assisted trabeculotomy(MAT)on corneal biomechanics and visual acuity in patients with primary open angle glaucoma(POAG).Methods The clinical data of 90 patients(90 eyes)with POAG admitted to the hospital from August 2020 to August 2022 were retrospectively analyzed,including 56 patients(56 eyes)treated with GATT and 34 patients(34 eyes)treated with MAT,and all procedures were performed by the same operator.Propensity scores were matched according to gender and age,and 30 patients(30 eyes)were enrolled in each of the GATT and MAT groups.The baseline data,surgical success rate,and preoperative and postoperative IOP at 1 week,1 month,and 3 months,the number of antiglaucoma medications used,and corneal biomechanical parameters[applanation-1 time(A1T),applanation-2 time(A2T),time to highest concavity(HCT),deformation amplitude(DA),and peak distance(PD)],visual acuity,and complication occurrence.Results IOP was lower in both groups at 1 week,1 month and 3 months after surgery than before surgery,the number of anti-glaucoma drugs used and A1T were lower than before surgery,and A2T,DA,PD and visual acuity were higher than before surgery,and the differences were statistically significant(all P<0.05).At 1 week,1 month and 3 months after surgery,there were no statistically significant differences in IOP,number of anti-glaucoma medications used,A1T,A2T,DA,PD and visual acuity between the GATT and MAT groups(t=0.384,0.318,1.187;0.289,1.933,0.687;0.610,0.197,0.279;0.062,0.856,0.046;0.369,0.899,0.125;0.310,0.619,0.643;0.264,0.089,0.273;0.701,1.879,1.519;P=0.703,0.751,0.066;0.774,0.058,0.495;0.544,0.844,0.782;0.951,0.396,0.963;0.714,0.373,0.901;0.758,0.538,0.523;0.793,0.929,0.786;0.486,0.065,0.134).There was no statistically significant difference between the GATT and MAT groups in terms of complete and conditional success rates(χ^(2)=0.739,1.456,P=0.390,0.228).There was po
作者
孟佳
杨鑫
高莎莎
MENG Jia;YANG Xin;GAO Sha-sha(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《医药论坛杂志》
2023年第8期6-11,共6页
Journal of Medical Forum
基金
河南省高等学校重点科研项目计划(23A320063)。
