改良式小梁切除术治疗青光眼的临床观察

目的研究羊膜应用于小梁切除术的临床疗效。方法将49例（52只眼）采用巩膜瓣下羊膜植入术,术后观察视力、眼压、滤泡及并发症。术后随访（11.6±7.1）个月。结果视力提高15只眼（34.51%）,功能性滤泡形成50只眼（96.15%）,46只眼（92.00%）眼压8.7~21.87 mm Hg,平均（16.5±5.66）mm Hg,6只眼（11.53%）需联合1种降眼压药物控制眼压,眼压基本稳定。结论羊膜应用于小梁切除术可有效地防止滤过泡的瘢痕组织形成,并能有效的长期保留功能性滤泡。     

干燥羊膜移植联合复合式小梁切除术治疗难治性青光眼临床观察

目的探讨干燥羊膜移植联合小梁切除术治疗难治性青光眼的有效性和安全性。方法采用国产干燥羊膜移植联合复合式小梁切除术治疗难治陛青光眼32例（39眼）,术后随访6～24个月,检查记录术后视力、滤过泡、前房深度、眼压及术后并发症等情况。结果随访期间眼压由术前（41.3±5．1）mmHg降至术后（17．2±5．3）mmHg,比术前降低59．9％,P〈0．001。手术总成功率为93．4％,保持功能性滤过泡34眼（87．2％）,术后视力提高2行以上者为27眼（69．2％）,并发症主要包括浅前房（5眼）、低眼压（9眼）和前房积血（4眼）。结论羊膜移植联合复合式小梁切除术可减少滤过道疤痕的形成,提高手术的成功率,是治疗难治性青光眼安全有效的方法之一。     

三枚可调整缝线在复合小梁切除术中的应用

目的观察三枚可调整缝线在原发性闭角型青光眼患者复合小梁切除术中的应用效果。方法 24例(38眼)原发性闭角型青光眼手术患者随机分为两组,分别采取三枚(A组,11例)或两枚(B组,13例)可调整缝线的复合小梁术,比较两组术后眼压、前房深度及滤泡等。结果 A、B组术后2周眼压[(11.9±2.2)mm Hg vs.(12.6±2.4)mm Hg]和术后2个月眼压[(13.3±2.4)mm Hg vs.(14.1±2.3)mm Hg]的差异均无统计学意义(P>0.05)。术后2周内A组浅前房发生率5.6%,明显低于B组的10.0%(P<0.05)。术后2个月时,A组功能滤过泡(I型和Ⅱ型)形成有18眼(100%),明显多于B组的18眼(90%)(P<0.05)。结论与两枚可调整缝线法相比,三枚可调整缝线法术后早期浅前房更少,功能滤过泡形成更好。     

The effect of intravitreal triamcinolone on intraocular pressure

ABSTRACT

Objective: To evaluate the effect of triamcinolone acetonide (ITA) on intraocular pressure (IOP) following intravitreal injection, and, in those patients who experience post-injection elevation of IOP, to determine the time course, effect of multiple injections, and risk factors for the pressure rise.

Methods: A retrospective chart review of 85 consecutive patients who received ITA (0.1?mL of 40?mg/mL solution) at the University of Texas South­western Medical Center between January 2002 and April 2004 was performed. Patient age, history of open-angle glaucoma (OAG), previous intraocular surgery, prior steroid exposure, type of retinal pathology treated, pre- and post-injection IOP, and post-injection glaucoma medications were tabulated. Patients with previous exposure to topical, intraocular or systemic steroids, and those without at least 16 weeks of follow-up were excluded. A student's paired t?test was used for statistical analysis.

Results: Seventy-seven eyes of 70 patients were included. Forty-eight eyes (62.3%) experienced an increase in IOP of at least 5?mmHg. Twenty-five eyes (32.5%) experienced elevation in IOP of 5–9?mmHg, and 23 eyes (29.9%) experienced an increase in IOP of ≥ 10?mmHg during the review period. The mean time for elevations of 5–9?mmHg and ≥ 10?mmHg to occur following injection were 6.9 weeks and 8.8 weeks, respectively. Fifty percent of eyes (3/6) in patients with OAG experienced a maximum IOP level of > 30?mmHg. Of all eyes with IOP elevation following injection, 32.5% required topical glaucoma therapy. Thirteen eyes received a second ITA injection. All eight eyes with IOP elevation after the first injection experienced another rise in IOP after the second. Of the five eyes which had no rise in IOP after the first injection, four had no rise after the second. At the final visit, 50% of eyes (3/6) with OAG required additional glaucoma medication compared to baseline. No patients required surgery for IOP control during the period under review.

Conclusions: ITA is frequently associated with a signif­icant elevation in IOP, typically within the first 2?months after injection. Most patients who do not have an elevated IOP after an initial injection will not experience a pressure rise after an additional one. About one-third will require topical glaucoma therapy for IOP control. Patients with OAG may be more difficult to control and require a longer duration of therapy. The inconsistent post-injection follow-up visit intervals among patients in this retrospective review may have affected our results, as some patients with maximum IOP changes may have been missed between office visits. In addition, practice patterns among treating physicians typically differ as to thresholds for the treatment of elevated IOP. A randomized, prospective, controlled trial could better address these issues.     

改良式小梁切除术治疗青光眼的临床观察

目的 研究羊膜应用于小梁切除术的临床疗效。方法 将49例（52只患眼）采用巩膜瓣下羊膜植入术，术后观察视力、眼压、滤泡及并发症：术后随访（11．6±7．1）个月。结果 视力提高15只患眼（34．51％），功能性滤泡形成50只患眼（96．15％），46只患眼（92．00％）眼压8．7～21．87mmHg，平均（16．5±5．66）mmHg，6只患眼（11．53％）需联合1种降眼压药物控制眼压，眼压基本稳定。结论 羊膜应用于小梁切除术可有效地防止滤过泡的瘢痕组织形成，并能有效的长期保留功能性滤泡。     

丝裂霉素C、环孢霉素A联合抗纤维增殖的实验研究

目的 研究丝裂霉素-C、环孢霉素-A联合抗纤维增殖的作用.方法 将35只健康日本大耳白兔随机分为5组,即实验组(0.1 mg/ml MMC 2%CsA组)、对照组1(0.2 mg/ml MMC组)、对照组2(2%CsA组)、对照组3(0.1 mg/ml MMC组)、对照组4(NS液组),均行全层巩膜咬切术.实验组术中在巩膜咬切区Tenon囊下放置0.1 mg/ml MMC棉片5分钟,NS溶液10 ml冲洗棉片放置区;然后在巩膜咬切区Tenon囊下放置2%CsA棉片5分钟,NS溶液10 ml冲洗棉片放置区.在对照组,在巩膜咬切区Tenon囊下分别放置0.2 mg/ml MMC、2%CsA、0.1 mg/ml MMC、NS液的棉片5分钟,NS溶液10 ml冲洗棉片放置区.术后14天内每天用裂隙灯观察滤过泡、角膜、前房;术后3、7、14天测量眼压;术后14天摘除眼球作病理和电镜检查.结果 0.1 mg/ml MMC 2%CsA组滤过泡形成率高,眼压下降明显、巩膜咬切口处成纤维细胞数少,无明显副作用.结论 0.1 mg/ml MMC 2%CsA抗增殖作用良好且无明显副作用,值得进一步研究.     

丝裂霉素C联合Ahamed青光眼阀植入术治疗难治性青光眼的疗效观察

目的:探讨应用MMC联合Ahamed青光眼阀植入治疗难治性青光眼的临床疗效。方法:应用MMC联合Ahamed青光眼阀植入术治疗难治性青光眼17眼17例。结果:术前眼压45.6+8.49mmHg,术后降至20.2+6.84mmHg,视力有不同程度的提高。术后并发症4例早期术后浅前房,2例前房积血,1例引流管内口堵塞。结论:应用MMC联合Ahamed青光眼阀植入,可以有效地降低难治性青光眼的眼压,减少术后并发症的发生。     

Intraocular pressure reduction in the untreated fellow eye after selective laser trabeculoplasty

ABSTRACT

Objective: To investigate the effect of selective laser trabeculoplasty (SLT) on the intraocular pressure (IOP) of untreated fellow eyes in patients with open-angle glaucoma.

Study design: Retrospective chart review.

Patients and methods: Charts of all patients who underwent SLT at the University of Texas Southwestern Medical Center at Dallas between September 2003 and May 2006 were reviewed. Each patient had IOP measurements by Goldmann applanation tonometry in both eyes preoperatively, and at 1 hour, 2 weeks, 3 months, and 6 months postoperatively. Patient age, gender, diagnosis, central corneal thickness (CCT), previous intraocular surgeries, and degrees of laser treatment were tabulated for each patient. Patients with a history of previous glaucoma surgery in either eye were excluded as were those who underwent any change in glaucoma medications or further laser or surgical intervention in either eye within 6 months of SLT. Data were analyzed using a paired two-tailed t-test, an unpaired two-tailed t-test, ANOVA, and linear regression.

Results: A total of 43 patients were included through 6 months of follow-up. Mean reduction in IOP in the treated eye was 3.9?±?0.6?mmHg or 18.8% (p?<?0.001) at final exam. Mean IOP reduction in the fellow untreated eye was 2.1?±?0.5?mmHg or 11.2% (p?<?0.01). Patients with higher preoperative IOPs had a greater reduction in IOP in both eyes (p?<?0.001 for treated eyes, and p?=?0.02 for untreated eyes). Patients who were on a larger number of glaucoma medications preoperatively had a greater response in both eyes (treated eye p?=?0.002, untreated eye p?=?0.008). There was no significant difference in IOP response in either eye based on age, gender, CCT, degrees of treatment, or phakic status.

Conclusions: SLT produces a sustained and statistically significant IOP reduction in the fellow untreated eyes of patients with open-angle glaucoma. The results of our study support a biological mechanism of action for SLT. Limitations of this study include its retrospective design, relatively small sample size, a possible effect of increased compliance with medical therapy following SLT, and an inherent bias of excluding patients who underwent a change in medications or further laser or surgical therapy during the period under review.     

Ocular hypotensive efficacy of travoprost in patients unsuccessfully treated with latanoprost

SUMMARY

Objective: To evaluate the efficacy of travoprost 0.004% monotherapy in patients unsuccessfully treated with latanoprost monotherapy.

Research design and methods: Open-label, non-comparative study conducted at US academic and private practice clinics in adult patients with ocular hypertension or primary open-angle glaucoma who required a change in therapy (due to either inadequate efficacy or safety issues) as judged by the investigator. Intraocular pressure (IOP) was measured at entry and 30?days later.

Main outcome measures: Mean change in intra-ocular pressure (mm Hg).

Results: Reported here are 488 per-protocol patients from 330 centers who were using latanoprost monotherapy prior to study entry, and who received travoprost monotherapy during the study. Patients had a mean age of 69?years, were approximately two-thirds Caucasian, 60% female, predominantly brown or blue eyes, and 91% were diagnosed as having primary open-angle glaucoma. The mean days in treatment were 31.9 ± 6.4. Mean IOP at study entry was 21.2?mm Hg. Following travoprost monotherapy, this was reduced by a mean of 3.2?mm Hg to 18?mm Hg (?p < 0.0001, paired t-test). There were 21 adverse events reported in the intent-to-treat (ITT) population for an incidence of 3.5%. There were some limitations to the current study including: no washout period, no control therapy, single IOP determinations at the beginning and the end of the study; patient compliance with the initial therapy was not measured, and the study was not masked. This study reflects a real-life situation of what a clinician can expect when he changes a patient from latanoprost monotherapy to travoprost monotherapy.

Conclusion: This study showed that travoprost provided a statistically and clinically significant reduction (?p < 0.0001) in IOP of 3.2?mm Hg for patients who had not been successfully treated with latanoprost monotherapy. The results of this trial demonstrate the potential benefit of using travoprost as a replacement therapy in order to ensure adequate IOP control.     

Ocular hypotony after the use of indocyanine green for epiretinal membrane surgery

Purpose: To report the occurrence of transient ocular hypotony after indocyanine green (ICG)-assisted macular surgery for removal of the epiretinal membrane (ERM).

Materials and methods: This was a retrospective review of 122 eyes of 118 patients who underwent vitrectomy for idiopathic ERM. The ICG staining technique was used in 71 eyes without fluid–air exchange (FAX) and in 15 eyes with FAX. Detailed eye examinations, including intraocular pressure (IOP) measurement, were performed before and after surgery.

Results: We observed postoperative transient ocular hypotony with choroidal detachment in 8 of 71 eyes (11%) in the ICG (+)/FAX (?) group, and no ocular hypotony was seen in the ICG (+)/FAX (+) group (15 eyes) or in the ICG (?) group (36 eyes). The median best corrected visual acuity (BCVA) in the ICG(?)group was only significantly better than in the ICG (+)/FAX (?) with hypotony at 1 week after surgery (p?=?0.046). However, there was no statistically significant difference in BCVA at 3 and 6 months after surgery among the groups (p?>?0.05).

Conclusion: ICG staining of the internal limiting membrane (ILM) supports complete ERM removal because of enhanced visualization of the border between the ILM and the ERM. However, it should be cautioned that postoperative ocular hypotony may occur in some cases of ICG-assisted macular surgery. Therefore, informed consent with careful follow-up is required when ICG-assisted surgery is performed.     

小切口白内障手术联合隧道内小梁切除术治疗白内障青光眼26例临床疗效观察

目的：探讨小切口白内障手术联合隧道内小梁切除术治疗白内障青光眼临床疗效。方法对26眼白内障合并青光眼的患者,行小切口白内障摘除人工晶体植入联合小梁切除术,术后观察术眼视力、眼压、滤过泡、并发症等情况,术后随访6个月。结果术后6个月随访时,23眼（88.5%）术后视力有不同程度的提高,其中术后视力大于0.3有19眼（73.1%）。术前及术后各观察时间点眼压值比较发现,术后眼压均比术前有所下降,差异有统计学意义（P〈0.05）;术后各观察时间点眼压值两两比较发现,差异均无统计学意义（P〉0.05）。术后有23眼（88.5%）形成弥漫扁平的功能性滤过泡,其中Ⅰ型滤过泡14眼,Ⅱ型滤过泡9眼。术后有角膜水肿7眼,浅前房3眼,术中术后未见严重的并发症。结论小切口白内障手术联合隧道内小梁切除术治疗白内障合并青光眼,不但能很好的控制眼压,迅速恢复视力,而且并发症少,该方法是一种安全、有效、经济、实用的手术方法,值得临床应用。     

改良小梁切除术治疗青光眼的疗效观察

目的探讨改良小梁切除术与小梁切除术治疗青光眼的术后疗效比较与分析。方法选取青光眼患者95例(95眼)随机分成观察组49例(49眼),对照组46例(46眼),分别行改良小梁术与小梁切除术。结果经统计学处理,术后早期眼压控制情况与前房形成情况无显著性差异(P>0.05),但术后远期眼压控制情况与功能性滤过泡形成情况比较有显著性差异(P<0.05)。结论改良小梁切除术较小梁切除术具有良好的远期眼压控制效果和形成良好的功能性滤过泡,减少了手术并发症的优点。     

低浓度丝裂霉素联合羊膜移植治疗原发性青光眼的近期疗效分析

目的探讨羊膜移植联合低浓度丝裂霉素、小梁切除治疗原发性青光眼的效果。方法选择本院2011年6月～2012年12月收治的42例（60眼）原发性青光眼患者,将其随机分为研究组22例（30眼）和对照组20例（30眼）,研究组患者给予小梁切除、羊膜移植联合低浓度丝裂霉素治疗,对照组患者给予小梁切除治疗,观察两组患者治疗后眼压、视力的改变情况,并统计两组患者的并发症情况。结果研究组患者术后视力改善优良率明显高于对照组,组间差异有统计学意义（P〈0．05）;两组术后1、6个月眼压均较治疗前明显降低,差异有统计学意义（P〈0．05）;研究组术后1、6个月时的眼压明显低于对照组（P〈0．05）;研究组复发率及并发症发生率明显低于对照组,差异有统计学意义（P〈0．05）。结论低浓度丝裂霉素、羊膜移植、小梁切除治疗原发性青光眼可有效改善患者视力,眼压控制满意,复发率及并发生症发生率较低,值得推广。     

复合式小梁切除术的临床分析

目的:探讨复合式小梁切除术的临床疗效及其并发症的预防措施.方法:48例(52眼)青光眼小梁切除术中联合应用丝裂霉素C及巩膜瓣可调整缝线技术,随访6～12个月,观察视力、眼压、滤过泡、前房、眼底及视野,并总结手术并发症的预防措施.结果:术后5眼(9.62%)视力下降,2周内恢复至术前.5眼(9.62%)眼压超过21mmHg(1mmHg=0.133Kpa),经相应处理后眼压降至正常.47眼眼压正常,为功能性滤过泡.-型浅前房6眼(11.53%),滴1%阿托品眼液1周后恢复正常.2眼(3.85%)前房少量积血,3天内自行吸收.3眼(5.77%)明显前葡萄膜炎,用药后2周内好转.3眼视盘杯盘比进展性增大及视野缺损进展性加重,眼压控制后杯盘比及视野均能稳定.结论:复合式小梁切除术治疗青光眼疗效满意,但应尽量预防其并发症的发生.     

Intraocular pressure reduction with travoprost/timolol fixed combination,with and without adjunctive brinzolamide,in glaucoma

ABSTRACT

Objective: To investigate if combined intraocular pressure (IOP)-lowering medication with travoprost/timolol fixed combination and a carbonic anhydrase inhibitor, brinzolamide, is superior to both travoprost monotherapy and travoprost/timolol fixed-combination therapy in primary open-angle glaucoma and ocular hypertension.

Methods: Following a 4-week wash-out period and using 4-week long treatment periods, 20 primary open-angle glaucoma or ocular hypertension patients were treated with evening travoprost 0.004?%?, then switched to evening travoprost 0.004?%?/timolol 0.5?%?fixed combination, and finally the treatment was combined with adjunctive twice-daily brinzolamide 1?%?ophthalmic suspension. Both eyes were treated, but only one eye per patient (the eye with the higher mean diurnal IOP at baseline), was evaluated. IOP was measured at 8 a.m., 12 noon and 4 p.m. at baseline and at the end of each treatment period.

Results: Mean diurnal IOP (mean (SD)) at baseline was 28.5 (7.3) mmHg which decreased to 22.3 (6.3) mmHg on travoprost, 19.2 (3.4) mmHg on travoprost/timolol fixed combination and 17.3 (3.4) mmHg when the brinzolamide was added to the travoprost/timolol combination (ANOVA, contrast test, p?<?0.003 for all comparisons). The individual time point IOP values showed similar and significant stepwise differences.

Conclusion: Adjunctive brinzolamide medication provided further IOP decrease in patients receiving evening-dosed travoprost/timolol fixed combination. The travoprost/timolol fixed combination was significantly more effective in IOP reduction than travoprost monotherapy, which by itself induced a significant IOP decrease compared to the untreated baseline value. The results of this open label study suggest that combined therapy with travoprost/timolol fixed combination and brinzolamide is clinically useful for IOP-lowering in primary open-angle glaucoma and ocular hypertension.     

Effects of selective serotonin reuptake inhibitors on intraocular pressure and anterior segment parameters in open angle eyes

Purpose: To evaluate the short- and long-term effects of selective serotonin reuptake inhibitors (SSRIs) on intraocular pressure (IOP) and anterior segment parameters in open angle eyes.

Materials and methods: This cross-sectional study included 325 eyes of 166 subjects. Subjects were divided into three groups: Group 1 included 116 eyes of 58 patients receiving SSRIs for 1?week–6?months, Group 2 included 102 eyes of 53 patients receiving SSRIs for longer than 6?months and Group 3 included 107 eyes of 55 healthy subjects not receiving any drugs. All of the patients receiving SSRIs were diagnosed as major depressive disorder. All groups were chosen to be similar in terms of age and gender. All patients underwent a detailed ophthalmologic examination including IOP measurement by Goldmann applanation tonometer and gonioscopy. Anterior segment parameters including pupil diameter (PD), central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle (ACA) were assessed by a Scheimpflug system.

Results: Pupil diameter was significantly larger in patients receiving SSRIs for <6?months and ≥6?months than the control subjects (3.53?±?0.71?mm, 3.48?±?0.60?mm versus 3.11?±?0.72?mm, p?p?Conclusions: Selective serotonin reuptake inhibitors cause mydriasis which is persistent during the treatment. In depression patients with open angle eyes, short- and long-term use of SSRIs leads to decrease in IOP.     

Evaluation of the effects on choroidal thickness of bimatoprost 0.03% versus a brinzolamide 1.0%/timolol maleate 0.5% fixed combination

Objective: To investigate the effects of two different medical treatment options on choroidal thickness (CT) in cases of open-angle glaucoma (OAG).

Methods: Sixty-seven eyes newly diagnosed with OAG and 52 healthy eyes constituting the control group were included in the study. Glaucomatous eyes were randomly divided into two subgroups; Group I was started on bimatoprost 0.03% and Group II on a brinzolamide 1.0%/timolol maleate 0.5% fixed combination (BTFC). Intraocular pressure (IOP), ocular pulse amplitude (OPA) and subfoveal CT measurements were performed in all eyes in the study before treatment and on weeks 2, 4 and 8 after treatment.

Results: Mean initial IOP values in groups I and II and the control group were 25.5?±?4.7, 25.1?±?5.2 and 16.1?±?2.9?mmHg, mean OPA values were 3.7?±?1, 3.6?±?1.4 and 2.4?±?0.6?mmHg and mean CT values were 269.4?±?83, 264.5?±?84.4 and 320.1?±?56.6?μm, respectively. Eight weeks after treatment, mean IOP values in Groups I and II and the control group were 18.3?±?2.6, 18.1?±?3.4 and 15.7?±?2.9?mmHg, mean OPA values were 2.9?±?1.2, 2.8?±?1.5 and 2.3?±?0.8?mmHg and mean CT values were 290.2?±?87.3, 271.8?±?82.5 and 319.3?±?56.8?μm, respectively. No significant difference was determined in terms of the decrease in IOP and OPA obtained after treatment in Group I and Group II. However, a significant difference was observed between the two groups in terms of choroidal thickening after treatment.

Conclusion: The use of topical ocular hypotensive medication in eyes with OAG results in an increase in CT. This increase is relatively greater with bimatoprost 0.03% therapy compared to BTFC.     

Adenovirus-mediated delivery of p27KIP1 to prevent wound healing after experimental glaucoma filtration surgery

Aim:

The aim of the study was to evaluate the outcome of adenovirus-mediated p27^KIP1 (Ad-p27) expression on wound healing after filtration surgery and to investigate the inhibition of cell proliferation induced by Ad-p27.

Methods:

We constructed the adenovirus recombinant vector Ad-p27 and administered it to a rabbit model of glaucoma filtration surgery by subconjunctival injection; phosphate-buffered saline (PBS) and mitomycin C (MMC) were used as controls. Intraocular pressure (IOP), bleb scores, and anterior chamber depths were observed during a 28-d period. Histological examinations, fluorescence observations and Western blot analyses were evaluated.

Results:

Ad-p27 enhanced the surgical outcome and inhibited cell proliferation when compared with PBS. Bleb scores in the Ad-p27-treated eyes were higher than those in the PBS-treated eyes on d 7 (P<0.01), 14 (P<0.01) and 21 (P<0.05). On d 28, IOP remained significantly decreased in the Ad-p27 group compared with the PBS group (P<0.05). However, no differences in bleb scores or IOPs were observed between the Ad-p27 and MMC groups. Histological analysis showed that total cell numbers were markedly reduced, and less scar tissue was observed at the surgical site in eyes treated with Ad-p27. The number of fibroblasts was decreased in Tenon''s capsule in Ad-p27-treated eyes; however, a marked and diffuse signal from the green fluorescent protein (GFP) was observed in fibroblasts. Western blot analysis revealed a high level of p27^KIP1 expression in conjunctival epithelium (P<0.01), relatively high expression in superficial scleral stroma (P<0.01), and low expression in corneal epithelium in the Ad-p27 group.

Conclusions:

Ad-p27 administration significantly improves the outcome of filtration surgery and inhibits postoperative proliferation in rabbit eyes. These findings suggest that p27^KIP1 is a potential adjunctive agent for inhibition of wound healing after filtration surgery.     

The long-term anatomical and visual effect of intravitreal triamcinolone injection during vitrectomy for the treatment of idiopathic macular epiretinal membrane

Purpose: To compare the long-term anatomical and visual outcomes of patients with idiopathic epiretinal membrane (ERM) removed by vitrectomy and membrane peeling with or without the use of intravitreal injection of triamcinolone acetonide (IVTA).

Methods: A retrospective chart review was performed. Subjects who underwent vitrectomy and who were followed over 12 months were included. The study included two groups of patients. In group 1 (71 eyes), the patients underwent vitrectomy and membrane peeling without the use of IVTA. In group 2 (27 eyes), 2?mg of IVTA was given at the end of the surgery. The main outcome measures were best-corrected visual acuity (BCVA), central foveal thickness (CFT) determined by optical coherence tomography (OCT), the number of cataract surgeries, and the use of anti-glaucomatous drugs during the follow-up period.

Results: This study included 98 eyes with ERM from 98 patients. There was no significant difference between the two groups with respect to age, gender, pre- and postoperative lens status, BCVA, CFT, or length of the follow-up period. The mean age for all of the patients was 62.45?±?10.01 (mean ± SD) years, and the mean follow-up length was 20.58?±?9.64 (mean ± SD) months. In all cases, the mean best-corrected logarithm of minimum angle of resolution (logMAR) acuity improved from a preoperative value of 0.91?±?0.32 [Snellen equivalent (SE), 0.16?±?0.14] to a postoperative value of 0.46?±?0.36 (SE, 0.46?±?0.29) (P?<?0.0001). The CFT was reduced from a preoperative value of 473.46?±?96.91 μm to a postoperative value of 302.44?±?69.80 μm (P?<?0.0001). Six patients (22.2%) in group 2 required anti-glaucomatous drugs to control intraocular pressure (IOP) during the follow-up period, and three patients (4.2%) in group 1 required drugs to control IOP (P?=?0.012).

Conclusions: The postoperative visual outcomes for patients with idiopathic ERM were favorable, but CFT did not return to a normal level, even in eyes in which 2?mg IVTA was used. The IVTA use after ERM removal produced no significant benefits during long-term follow-up, but IVTA did increase the risk of increased IOP.     

超声乳化白内障吸除联合小梁切除术治疗青光眼合并白内障

目的探讨临床中超声乳化白内障吸除术与小梁切除术联合治疗青光眼合并白内障的临床疗效与安全性。方法采取回顾性方法对我院2011年1月至2011年12月间超声乳化白内障吸除术与小梁切除术联合治疗的60例青光眼合并白内障临床资料进行分析。结果手术前患者眼压为(28.9±4.5)mm Hg,手术后患者眼压为(12.5±2.3)mm Hg,手术后患者的眼压较治疗前有明显的降低,数据的比较差异有统计学意义(P<0.05);手术治疗后患者的视力较治疗前有明显的改善,数据的比较差异有统计学意义(P<0.05);手术前功能性滤过泡率为23.3%,手术后功能性滤过泡率为91.7%,手术治疗后功能性滤过泡率明显的高于手术治疗前(P<0.05),统计学有意义。结论临床中对于青光眼合并白内障患者采取超声乳化白内障吸除术与小梁切除术联合治疗是可行的,能够有效的恢复其视力,改善眼压,并且不良反应也比较少,治疗安全性高,值得临床中应用与推广。