| Ex-PRESS引流钉植入术与小梁切除术治疗开角型青光眼的早期疗效比较 |
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| 引用本文： | 韩光杰,周和政,张文强,黄志坚,闫明. Ex-PRESS引流钉植入术与小梁切除术治疗开角型青光眼的早期疗效比较[J]. 眼科新进展, 2014, 0(8): 758-760. DOI: 10.13389/j.cnki.rao.2014.0208 |
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| 作者姓名： | 韩光杰 周和政 张文强 黄志坚 闫明 |
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| 作者单位： | 湖北省武汉市，南方医科大学附属武汉临床学院，广州军区武汉总医院，全军眼科中心 |
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| 摘 要： | 目的 对比观察Ｅｘ-ＰＲＥＳＳ引流钉植入术与小梁切除术治疗开角型青光眼（ｏｐｅｎａｎｇｌｅｇｌａｕｃｏｍａ，ＯＡＧ）的早期疗效与安全性。方法 回顾性分析在我院同一时期接受Ｅｘ-ＰＲＥＳＳ引流钉（Ｐ５０）植入术（２９例３３眼，Ｅｘ-ＰＲＥＳＳ组）与小梁切除术（２８例３６眼，小梁组）患者的临床资料，统计两组患者的病种构成、理论住院天数、并发症发生率、出入院时的视力和眼压变化情况，统计分析两种手术治疗ＯＡＧ的短期疗效与安全性。结果 Ｅｘ-ＰＲＥＳＳ组和小梁组患眼中男女比例分别为１．７５１、１．７７１（Ｐ＞０．０５）；年龄分别为（３９±３）岁、（４１±３）岁（Ｐ＞０．０５）。Ｅｘ-ＰＲＥＳＳ组中单纯的原发性开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎａｎｇｌｅｇｌａｕｃｏｍａ，ＰＯＡＧ）患者较少（Ｐ＜００５）。Ｅｘ-ＰＲＥＳＳ组和小梁组病例的理论住院时间分别为（３．１２±０．３３）ｄ、（４．４７±１．６７）ｄ（Ｐ＜００５），Ｅｘ-ＰＲＥＳＳ组的理论住院时间较短。Ｅｘ-ＰＲＥＳＳ组和小梁组的并发症发生率分别为０、８．３３％（Ｐ＜０．０５），Ｅｘ-ＰＲＥＳＳ组的并发症较少。Ｅｘ-ＰＲＥＳＳ组和小梁组患者手术前后视力变化平均值分别为０．００９、０．０９６（Ｐ＜０．０５），Ｅｘ-ＰＲＥＳＳ组术后视力下降较少。Ｅｘ-ＰＲＥＳＳ组和小梁组患者手术前后眼压下降值分别为（２２．０５±１３．２０）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ）、（２１．１１±１３５８）ｍｍＨｇ，两组手术前后眼压差异无统计学意义（Ｐ＞０．０５）。结论 Ｅｘ-ＰＲＥＳＳ引流钉植入术不仅能够达到小梁切除术相同的早期治疗效果，而且具有术后视力下降及并发症较少、术后恢复快、住院时间短等优点，除适用于单纯ＰＯＡＧ外，尤其适用于各种继发性ＯＡＧ和伴有危险因素ＰＯＡＧ患者。
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| 关 键 词： | Ex-PRESS引流钉植入术 小梁切除术 开角型青光眼 |
Comparison of therapeutic effect in early stage between Ex-PRESS implantation and trabeculectomy for open angle glaucoma |
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| HAN Guang-Jie,ZHOU He-Zheng,ZHANG Wen-Qiang,HUANG Zhi-Jian,YAN Ming. Comparison of therapeutic effect in early stage between Ex-PRESS implantation and trabeculectomy for open angle glaucoma[J]. Recent Advances in Ophthalmology, 2014, 0(8): 758-760. DOI: 10.13389/j.cnki.rao.2014.0208 |
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| Authors: | HAN Guang-Jie ZHOU He-Zheng ZHANG Wen-Qiang HUANG Zhi-Jian YAN Ming |
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| Abstract: | Objective To compare the therapeutic effect and safety in early stage between Ex-PRESS implantation and trabeculectomy for open angle glaucoma ( OAG) . Methods The clinical data of 57 cases with OAG treated with Ex-PRESS( P50) implantation( 29 cases,33 eyes) or trabeculectomy( 28 cases,36 eyes ) in our hospital during the same period were retrospectively analyzed , and the disease composition . theoretical days of hospitalization , incidences of complications and changes in visual acuity and intraocular pressure ( IOP) between admission and discharge were statistically evaluated. Results The rate of males and females in Ex-PRESS group and trabeculectomy group are l. 75 :1 and l. 77 :1 (P > 0. 05 ) , the age were ( 39 + 3) years old and (41 + 3) years old(P > 0. 05 ) . The disease composition of the two groups was sigruficantly different(P < 0. 05 ) with less pure primary open angle glaucoma ( POAG) cases in Ex-PRESS group. Theoretical days of hospitalization of Ex-PRESS group and trabeculectomy group were ( 3. 12 +0. 33 ) days and (4. 47 + 1. 67 ) days ( P < 0. 05 ) . The incidences of complications of Ex-PRESS group and trabeculectomy group were o and 8. 33% (P < 0. 05 ) . The changed value of visual acuity of Ex-PRESS group and trabeculectomy group were 0. 009 and 0. 096 ( P < 0. 05 . The decreased value of IOP of Ex-PRESS group and trabeculectomy group were ( 22. 05 + 13. 20) mmHg ( I kPa = 7. 5 mmHg ) and ( 21. 11 + 13. 58 ) mmHg(P > 0. 05 ) . Conclusion Although trabeculectomy and Ex-PRESS implantation provide a similar IOP control effect in early stage , Ex-PRE SS implantation shows a lot of advantages over trabeculectomy , such as lower rate of complications . shorter theoretical days of hospitalization , especially much smaller influence on visual acuity. In addition to pure POAG , Ex-PRESS implantation may be especially suit for almost all kinds of secondary OAG and POAG with risk factors. |
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| Keywords: | Ex-PRESS implantation trabeculectomy open angle glaucoma |
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