EX-PRESS青光眼引流器植入术治疗开角型青光眼

目的：EX-PRESS青光眼引流器植入术治疗开角型青光眼的临床疗效和安全性。方法：回顾经视力、眼压、房角镜、眼底、视野等检查确诊为开角型青光眼患者40例47眼。患者年龄6～73（平均39.9±16.5）岁，最佳矫正视力0.01～0.60，眼压18～65mmHg。给予3种以上降眼压药物控制不理想，行EX-PRESS青光眼引流器植入术。术后1，3d； 1wk进行眼压、裂隙灯检查。比较治疗前后最佳矫正视力、眼压的临床资料，观察其疗效及安全性。结果：术前平均视力0.26±0.29，术后1wk平均视力0.24±0.22，平均视力稍有下降，但无统计学意义（t=1.56，P=0.13）。术前平均眼压36.62±14.01mmHg，术后1，3d； 1wk平均眼压分别为10.04±5.77，9.59±4.93，9.47±3.06mmHg。EX-PRESS青光眼引流器植入术后1，3d； 1wk的眼压均较治疗前明显降低（F=157.20，P〈0.05）。除5眼术后1d眼压〈5mmHg，所有患者在治疗过程中及术后1wk均未见明显眼部或全身不良反应。结论：EX-PRESS青光眼引流器植入术治疗开角型青光眼是安全有效的，术中及术后风险低、并发症少。

Clinical observation of EX-PRESS glaucoma drainage device on open angle glaucoma

AIM: To investigate the safety and effect of EX-PRESS glaucoma drainage device on open-angle glaucoma.

METHODS: A retrospective review of 40 patients(47 eyes)whose eyes were diagnosed as open angle glaucoma through the best-corrected visual acuity(BCVA), intraocular pressure(IOP), gonioscope, examination of the ocular fundus, and visual fields et al. Fourty patients 6-73y old(mean 39.90±16.50y old)with the BCVA from 0.01 to 0.6 and the IOP from 18mmHg to 65mmHg were treated with EX-PRESS glaucoma drainage device after achieving not well IOP over three drugs. Follow-up of these patients 1d, 3d and 1wk after treatment, IOP, slit lamp examination were retrospectively observed. The changes of the BCVA, IOP were used to evaluate the safety and effect before and after treatmeat.

RESULTS: The mean BCVA was 0.26±0.29 pre-operatively, while it was 0.24±0.22 after treatment one week. The mean BCVA decreased slightly, but there was no statistic difference between pre-treatment and post-treatment(t=1.56,P=0.13). The mean IOP was(36.62 ±14.01)mmHg pre-operatively,(10.04±5.77)mmHg after treatment one day,(9.59±4.93)mmHg after treatment three days,(9.47±3.06)mmHg after treatment one week. The IOP was decreased significantly in post-treatment after one day, three days, one week compared with pre-treatment(F=157.20, P<0.05). Except for 5 eyes of the IOP below 5mmHg, there was no ocular or systemic adverse events observed in all patients.

CONCLUSION: EX-PRESS glaucoma drainage device is an effective and safe treatment for the patients with open-angle glaucoma. The risk and complication are low intraoperatively and postoperatively.