“Association of APOE gene polymorphisms with primary open angle glaucoma in Brazilian patients”

ABSTRACT

Background: Primary open-angle glaucoma (POAG) is a multifactorial disease that affects 65.5 million people worldwide. In addition to the genetic variants already established as indicators of greater risk for POAG, the apolipoprotein (APOE) gene has been studied in some populations, with controversial results. The aim of this study is to investigate the frequency of the genetic variants of APOE in the Brazilian population, and to evaluate the association between these polymorphisms and the risk of POAG.

Methods: APOE variants (rs429358; rs7412) were genotyped in 402 POAG patients and 401 controls. We evaluated the association between APOE genetic variants and the risk for POAG, as well as the correlation between the requirement of glaucoma surgery and the APOE polymorphisms.

Results: Among the three APOE gene isoforms, we found a low frequency of APOE alleles ε2 (7.34%) and ε4 (11.76%), but a high frequency of ε3 (80.88%) in our population. When compared to ε3ε3 reference genotype, ε2 allele-carriers (OR = 1.516; p-value = 0.04) and ε2ε3 genotype (OR = 1.655; p-value = 0.02) were associated with a greater risk for POAG. An additive genetic model confirmed the influence of the ε2 allele in the risk of POAG in this sample of the Brazilian population (OR = 1.502; p-value = 0.04). There was no significant association between the analyzed genotypes and the requirement or number of glaucoma surgeries (p > .05).

Conclusion: Brazilian individuals carrying the APOEε2 allele may be at an increased risk for the development of POAG.     

2%美开朗与0.5%噻吗心安滴眼液治疗开角型青光眼与高眼压症的临床对照研究

目的以噻吗心安滴眼液作对照,在原发性开角型青光眼和高眼压症患者中评价美开朗滴眼液的降眼压、内在拟交感活性作用。方法选择开角型青光眼和高眼压症患者50例50眼,随机分为美开朗组和噻吗心安组2组,各25例25眼。美开朗组滴用2%美开朗眼液,噻吗心安组滴用0.5%噻吗心安眼液,一日2次,共12周,比较两种滴眼液的降眼压作用及局部和全身副作用。结果两组患者用药后眼压均下降,与用药前相比均有显著性差异(P<0.01)。两组间眼压下降值无显著性差异(P>0.05)。用药12周,美开朗组心率平均降低3.6次,噻吗心安组心率平均降低6.5次,两者相比有显著性差异。结论美开朗滴眼液对开角型青光眼和高眼压症患者具有明显的降眼压作用,和噻吗心安滴眼液局部降眼压作用相同,但对心率的抑制作用比噻吗心安小。     

正常眼压青光眼与原发性开角型青光眼的比较

正常眼压青光眼（ＮＴＧ）的发病率逐渐增加,日益受到眼科工作者的重视。ＮＴＧ发病隐蔽,早期诊断较其它青光眼显得更为困难和复杂,其发病机制、诊断标准及其与原发性开角型青光眼（ＰＯＡＧ）的异同等一系列问题仍无统一意见。就ＮＴＧ与ＰＯＡＧ的诊断标准,发病机制,临床表现,治疗原则以及相互关系等问题的研究进展等进行综述。     

原发性开角型青光眼患者焦虑症伴随状况及特征分析

目的:了解原发性开角型青光眼(primary open angle glau-coma,POAG)患者焦虑症伴随状况及其影响因素。方法:用Hamilton焦虑量表(HAMD)对82例POAG患者及82例非青光眼患者进行焦虑测试,对比两组患者焦虑症伴随比率,并对82例POAG患者以不同性别、年龄、文化程度等进行分组比较,分析焦虑症发生的影响因素。结果:POAG组与对照组伴发焦虑者分别为13例(16%)和5例(6%),经χ2检验,差异有统计学意义(P=0.046)。对82例POAG患者内部分组比较显示:性别、年龄、文化水平、病程、视野为POAG伴发焦虑的相关因素。结论:POAG患者心理健康状况应予以关注,尤其对病程长、年龄大、文化程度低、视功能损害严重的女性患者,应同时给予心理评估及干预,以改善POAG患者的生活质量及预后。     

中药川芎嗪治疗原发性开角型青光眼视功能损害的疗效

目的：探讨中药川芎嗪对原发性开角型青光眼的血液流变学、眼底荧光血管造影以及视功能的影响。方法：采用双盲、随机、安慰剂对照的方法对眼压已控制的原发性开角型青光眼１９例（３４眼）,其中治疗组１１例（１９眼）,对照组８例（１５眼）进行治疗前后血液流变学测定、眼底荧光血管造影、Ｈｕｍｐｈｒｅｙ视野检查以及模型视诱发电位（ＰＶＥＰ）检测。结果：用磷酸川芎嗪治疗后,患者全血粘度明显降低;眼底荧光血管造影各充盈时间明显缩短;Ｈｕｍｐｈｒｅｙ静态视野之总缺失（ＴＤ）、平均缺失（ＭＤ）明显减少,动态视野之Ｉ４ｅ等视线面积明显扩大;１００′、２５′、６′三种方格ＰＶＥＰ的Ｐ１潜伏期明显缩短。结论：磷酸川芎嗪可以降低原发性开角型青光眼患者的血液粘度;缩短眼底荧光血管造影各循环时间,改善血流动力学;改善青光眼的视功能损害     

Inflammatory model in patients with primary open angle glaucoma and diabetes

AIM: To assess the inflammatory cytokines expression in aqueous humor in diabetic primary open angle glaucoma (POAG) patients. METHODS: A cross-sectional study on 87 eyes, distributed as following: 26 eyes from diabetic patients, 16 eyes with POAG and 21 eyes from diabetic POAG patients; healthy controls (24 eyes) were recruited from patients undergoing conventional cataract surgery. A volume of 100 μL of aqueous humor (AH) was collected during phacoemulsification and 21 inflammatory markers were quantified using a Luminex® cytometric bead assay: IL-1Ra, IL-1α, IL-1β, IL-5, IL-6, IL-10, IL-17, GM-CSF, IFNγ, CCL2, CCL3, CCL4, CXCL5, CXCL8, bFGF, VEGF, TNFα. Main changes in cytokine profile were analyzed and compared between groups. Data on demographics, duration of glaucoma, intraocular pressure (IOP), number of anti-glaucoma substances were recorded for correlation analysis and prediction models. RESULTS: Significant differences in cytokine expression between groups were detected for CXCL5 (P<0.001), CXCL8 (P=0.004), IL-1α (P<0.001), IL-2 (P<0.001), CCL4 (P=0.003), CCL5 (P<0.001) and TNFα (P=0.05). Post-hoc analysis identified IL-2 (P=0.009) and CXCL5 (P<0.001) as “separation markers” between POAG and diabetic POAG eyes. In POAG patients, the “separation markers” could highly predict the TNFα levels F(1, 16)=14.639, P<0.001, whereas in diabetic patients F(1, 24)=4.844, P=0.006 and diabetic POAG patients F(1, 19)=2.358, P=0.05 the level of prediction was inferior. CONCLUSION: Our results reveal an inflammatory model based on increased TNFα levels in POAG eyes. Simultaneous co-stimulatory molecules and additional inflammatory pathways need to be further explored in diabetic POAG cases, since the prediction model could only partially explain the increased TNFα level in this category of patients.     

原发性开角型青光眼的早期诊断

青光眼是全世界成人致盲的主要眼病。原发性开角型青光眼做为青光眼的一种类型,其特点是病程进展较为缓慢,多数没有明显症状,不易早期发现。许多患者就诊时已经出现了较严重的视功能障碍,且近年来该病患病率在临床上所占的比例有所上升。而对原发性开角型青光眼的早期诊断,是延缓或停止视功能进行性损害的关键。因此,综合国内外近年来相关文献,对原发性开角型青光眼的早期诊断做以下综述。     

Physical activity of patients with a primary open angle glaucoma

AIM: To assess physical activity (PA) including its intensity in primary open angle glaucoma (POAG). METHODS: PA was characterized by the use of questionnaires: Seven-Day Physical Activity Recall and Historical Leisure Activity Questionnaire. A questionnaire of 36 questions, developed by the authors, was used to assess the level of knowledge about glaucoma RESULTS: The study was conducted among 625 adults. The study group comprised 312 POAG patients aged over 40y, including 238 women (76%) and 74 men (24%). The control group consisted of 313 adults (>40 years old), including 202 (65%) women and 111 men (35%). The duration of current PA with an intensity of 4 metabolic equivalents (METs) was significantly shorter among people with POAG. PA in the past was significantly lower among people from the study group, regardless of gender. The level of glaucoma knowledge in patients with POAG was poor and significantly lower in men. CONCLUSION: Regular PA is an important and underestimated factor predisposing to the progression of POAG. There is a necessity to undertake educational and preventive actions with a view to modify the health behavior of glaucoma patients.     

Carotid artery ectasia coexistent with primary open angle glaucoma

A 60-year-old smoker presented with high intraocular pressure in the right eye with a right afferent pupil defect and visual field suggestive of primary open angle glaucoma in the right eye only, when an examination 2 years earlier had revealed no hint of ocular pathology. Radiological investigations demonstrated prominent ectasia of the internal carotid arteries extending into the proximal middle cerebral arteries. The changes in the carotids extended throughout the cavernous sinus regions, encroached on the under surface of the optic chiasm and were closely related to the internal aspects of both optic canals. In primary open angle glaucoma management, neural imaging is not normally recommended; however, neural imaging investigations should be considered if the presentation is not typical of a chronic bilateral optic neuropathy     

尼日利亚Gwagwalada原发性开角型青光眼患者的社会人口学和临床特征

目的：探讨比较尼日利亚Gwagwalada原发性开角型青光眼(POAG)与非青光眼患者的临床社会人口学特征。

方法：横断面对比研究。共调查235例成年患者,其中96例POAG及139例非青光眼。记录患者年龄、性别、教育程度、职业、种族、青光眼家族史、眼痒、糖尿病和高血压情况。眼部检查包括视力、中央视野、杯盘比、前房角评估和眼压。

结果：平均年龄为49.88±13.75岁,其中男114例(48.5%)。POAG患者包括42个种族,其中伊博人(24/96,25.0%)和约鲁巴人(20/96,20.8%)最为常见。大多数POAG(74/96,77.1%)年龄在40-69岁之间。POAG(73/96,76.0%)有不同程度的视力障碍。POAG组与非青光眼组的对比如下：青光眼阳性家族史(34/96,35.4%)vs(25/139,18.0%; P=0.012); 糖尿病史(8/96,8.3%)vs(6/139,4.3%); 高血压病史(24/96,25.0%)vs(28/139,20.1%); 糖尿病合并高血压病史(1/96,1.0%)vs(4/139,2.9%; P=0.268); 使用抗糖尿病药物者(5/96,5.2%)vs(7/139,5.0%); 使用降压药者(24/96,25.0%)vs(23/139,16.5%); 联合使用抗糖尿病和抗高血压药物者(4/96,4.2%)vs(5/139,3.6%; P=0.328); 有眼痒症状者(18/96,18.7%)vs(37/139,26.6%; P=0.328); 视力障碍\〖右眼(RE)：51/96,53.1%; 左眼(LE)：60/96,62.5%\〗vs(RE：40/139,28.7%; LE：37/139,26.6%; P=0.000); 垂直杯盘比>0.4(RE：96/96,100%; LE：96/96,100%)vs(RE：131/139,94.2%; LE：124/139,89.2%)(RE：P=0.307; LE：P=0.006); 眼压>22 mmHg(RE：17/96,17.7%; LE：22/96,22.9%)vs(RE：2/139,1.4%; LE：2/139,1.4%; P=0.006)。大多数POAG患者(60/96,62.5%)正在服用抗青光眼药物,(23/96,24.0%)尚未开始用药,P=0.000。许多POAG(32/96,33.3%)正在服用β受体阻滞剂、前列腺素抑制剂和碳酸酐酶抑制剂的联合抗青光眼药物。

结论：青光眼具有与其他眼部疾病不同的临床社会人口学特征。许多参与者肯定了青光眼的家族史,大多数青光眼参与者正在接受抗青光眼治疗。包括失明在内的视力障碍与青光眼显著相关。该研究证实,开角型青光眼与高杯盘比和高眼内压有关。     

Using the Utah Population Database to assess familial risk of primary open angle glaucoma

Purpose

Primary open angle glaucoma (POAG) is a leading cause of irreversible blindness in the elderly. Previous epidemiological studies have identified family history, ethnic origin, age, high intraocular pressure and diabetes mellitus as risk factors. However, it is difficult to assess the extent family history plays in this disease process. The Utah Population Database (UPDB), created by the University of Utah, has recently become a resource for which greater than 9 million records are available for use. The UPDB is divided into two major data sets from which family members can be identified, namely 1.6 million genealogy records and 2 million Utah birth certificates. This study utilizes these resources to assess the familial risk of POAG within the Utah Population.

Methods

The University of Utah’s hospital and clinic records were searched for patients with primary and chronic open angle glaucoma (ICD9 codes 365.04 and 365.11) between the years 1995 and 2005. A case-control analysis was then performed with specialized UPDB software that was modified to constrain the control and pedigree populations to over 1 million University of Utah-UPDB linked records. Controls were matched to cases by gender and birth year (±2.5 years) with only one control being used per case. Population-attributable risk (PAR) to familial factors and relative risk (RR) were computed using conditional logistic regression (CLR).

Results

From the original 1.5 million medical records, 6198 patients with glaucoma were identified. Of these, 3391 met the inclusion criteria, which required patients to have at least one parent or one child in the UPDB. The PAR in this population was found to be 0.20, indicating 20% of the risk for glaucoma is attributable to genetic factors. CLR computations also showed a significantly increased relative risk (p < 0.05) in first cousins (RR = 1.45 (95% confidence interval (CI) 1.16-1.8)), second cousins (RR = 1.19 (95% CI 1.08-1.32)), siblings (RR = 3.76 (95% CI 2.66-5.31)), parents (RR = 6.25 (95% CI 3.94-9.9)) and children (RR = 6.77 (95% CI 3.39-13.5)).

Conclusions

Based on these familial data, there is a significantly higher prevalence of glaucoma in both first and second generation relatives of those affected as compared to relatives in the control group. When compared with other epidemiologic studies, such as an analysis of first-degree relatives of patients from the Rotterdam study, which showed a PAR of 16%, our study actually demonstrates a greater familial contribution to glaucoma. The UPDB is a valuable and unique resource providing a large population from which to analyze the familial risk of glaucoma.     

Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma and pseudoexfoliation glaucoma

AIM: To compare the effect of phacoemulsification on intraocular pressure (IOP) in patients with primary open angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG). METHODS: A retrospective comparative case series conducted at the Glaucoma Department at the Association to Prevent Blindness in Mexico. The study enrolled consecutive patients having phacoemulsification with intraocular lens (IOL) implantation and a diagnosis of POAG or PXG. Data about IOP values and number of glaucoma medications used was collected at baseline, 1, 3, 6 and 12mo postoperatively. RESULTS: The study enrolled 88 patients (88 eyes). After phacoemulsification, there was a statistically significant reduction in IOP values and glaucoma medications use compared to baseline in both POAG and PXG patients (P<0.001). In the POAG group, a 20% decrease in IOP values was evidenced, and a 56.5% reduction in the number of medications used at the one-year follow-up. The PXG group showed a 20.39%, and a 34.46% decrease in IOP and number of medications used, respectively. A significant difference in the mean ΔIOP (postoperative changes in IOP) was evidenced between groups (P=0.005). The reduction of the postsurgical IOP mean values in both groups, the POAG group showed a greater reduction in IOP values compared to the PXG group. CONCLUSION: In both types of glaucoma, phacoemulsification cataract surgery can result in a significant IOP reduction (20%) over a 12mo follow-up period. The number of medications used is also significantly reduced up to 12mo after surgery, especially in the PXG group.     

开角型青光眼图形视诱发电位与定量静态视野联合检测研究

目的 观察原发性开角型青光眼眼压、视野与Ｐ－ＶＥＰ Ｐ１００波潜时之间的关系。通过改变空间频率（１２０′、６０′、３０′）选择青光眼电生理学诊断最佳刺激参数。方法 对２４例（３０只眼）原发性性开角型青光眼进行眼压、定时静态视野及Ｐ－ＶＥＰ检测。分析眼压、定时静态视野Ｐ－ＶＥＰ Ｐ１００波潜时关系。检测结果进行统计学分析。结果 眼压、定时静态视野缺损程序与Ｐ－ＶＥＰ Ｐ１００波潜时变化呈正相关。高空     

Mutations in the third exon of the MYOC gene in Spanish patients with primary open angle glaucoma

Primary open angle glaucoma (POAG) is the second most common cause of blindness in developed countries. It is an optic neuropathy in which a degeneration of the retinal ganglion cells causes a characteristic excavation in the optic disc. Several loci have been identified to be responsible for different types of glaucoma, including the MYOC gene located on chromosome 1. In this work, six mutations have been identified in the third exon of the MYOC gene in patients with POAG. We studied 79 Galician patients with chronic POAG glaucoma and 90 control individuals from the same general population. We identified six mutations, including three novel ones. Two of the six mutations were considered to be polymorphisms, while the other four met the criteria for pathogenicity in this disease as they altered the amino acid sequence and were found in one or more patients with glaucoma and in less of 1% of the control population. These mutations were detected in eight patients suffering from POAG (7.5%) and in two people from the control population (2.2%). POAG can be due to mutations in the myocilin gene (MYOC) on chromosome 1. The glaucoma phenotype associated with this gene may vary from a juvenile severe form to a late-onset chronic open angle glaucoma.     

Selective laser trabeculoplasty in patients with pseudoexfoliative glaucoma vs primary open angle glaucoma: a one-year comparative study

AIM: To compare the efficacy of single-session 360-degree selective laser trabeculoplasty (SLT) for reduction of intraocular pressure (IOP) in patients with pseudoexfoliative glaucoma (PXFG) and primary open angle glaucoma (POAG). METHODS: This is a single-center, prospective, nonrandomized comparative study. Patients older than 18 years of age with uncontrolled PXFG or POAG eyes requiring additional therapy while on maximally tolerated IOP-lowering medications were included. The primary outcome measure changed in IOP from baseline. Success was defined as IOP reduction ≥20% from baseline without any additional IOP-lowering medication. All patients were examined at 1d, 1wk, 1, 3, 6, 9, 12mo after SLT. RESULTS: Nineteen patients (20 eyes) with PXFG and 27 patients (28 eyes) with POAG were included in the study. In the visual fields mean deviation was -2.88 (±1.67) in the POAG and -3.1 (±1.69) in the PXFG groups (P=0.3). The mean (±SD) IOP was 22.9 (±3.7) mm Hg in the POAG group and 25.7 (±4.4)?mm Hg in the PXFG group at baseline and decreased to 18.4 (±3.2) and 18.0 (±3.9) mm Hg in the POAG group (P<0.001 and P=0.02), and to 17.9 (±4.0) and 21.0 (±6.6) mm Hg in the PXFG group (P<0.001 and P=0.47) at 6 and 12mo, respectively. The number of medications was 2.6 (±0.8) in the POAG group and 2.5 (±0.8) in the PXFG group at baseline, and did not change at all follow-up visits in both groups (P=0.16 in POAG and 0.57 in PXFG). Based on Kaplan-Meier survival analysis, the success rate was 75% in the POAG group compared to 94.1% in the PXFG group (P=0.08; log rank test) at 6mo, and 29.1% and 25.0% at 12mo, respectively (P=0.9; log rank). CONCLUSION: The 360-degree SLT is an effective and well-tolerated therapeutic modality in patients with POAG and PXFG by reducing IOP without any change in number of medications. The response was more pronounced early in the postoperative period in patients with PXFG whereas there was no statistically significant difference at 12-month follow-up.     

Normal tension glaucoma: diagnostic features and comparisons with primary open angle glaucoma

Background : A significant proportion of patients diagnosed under the broad classification of open angle glaucoma actually has normal tension glaucoma (NTG). It has many clinical features that overlap with primary open angle glaucoma (POAG), yet there is a question of whether it has a different aetiology in which intraocular pressure plays less of a role. Methods : The epidemiology and clinical features of normal tension glaucoma are reviewed with particular reference to possible differences from primary open angle glaucoma, which might permit differentiation. The pathophysiology is discussed, outlining recent research in cell death (apoptosis), axonal damage and neuroprotection. Discussion and Conclusion : There is considerable evidence that NTG develops with little contribution from the effect of intraocular pressure. However, the clinical diagnosis of NTG is often one of exclusion and the differentiation of NTG from POAG remains difficult because many clinical signs are suggestive but not definitive of NTG. More accurate diagnosis may be possible when individual patients exhibit a greater number of signs. Some evidence suggests that NTG with relatively high pressures (greater than 15 mmHg) is more likely to progress than NTG with relatively low pressures. Clinicians must be particularly alert to the possibility of NTG because IOP, a clinical marker for some glaucomas, is absent.     

圖形視誘發電位和圖形視網膜電圖對原發性開角型青光眼的診斷研究

目的探討圖形視誘發電位(PVEP),圖形視網膜電圖(PERG)在不同時間頻率對原發性開角型青光眼診斷的敏感性.方法將原發性開角型青光眼分爲3組,記録不同時間頻率PERG、PVEP的變化,并舆正常組進行比較.結果當時間頻率在6Hz以上時,可疑青光眼PERG b波振幅明顯下降,而PVEP的P100振幅變异性大,下降不明顯.結論當時間頻率高時,用PERG更易檢測出早期原發性開角型青光眼.     

Estrogen receptor gene polymorphisms and their influence on clinical status of Caucasian patients with primary open angle glaucoma

ABSTRACT

Purpose: The aim of this study was to evaluate the frequency of single nucleotide polymorphisms (SNP) of estrogen receptor genes (ESR1: rs12154178, rs1884054 and ESR2: rs1268656, rs7159462) and to assess their possible influence on the clinical phenotype of primary open angle glaucoma (POAG).

Methods: The study included 235 patients with POAG (143 patients with normal-tension glaucoma [NTG] and 92 patients with high-tension glaucoma [HTG]), and 165 healthy controls. DNA was isolated from peripheral blood, and SNP genotyping was performed using the Real-Time Polymerase Chain Reaction method to analyze the frequency of selected polymorphic variants of estrogen receptor genes. The clinical phenotype (best-corrected visual acuity, intraocular pressure [IOP], mean deviation [MD], cup to disc ratio, disc hemorrhages, notches, peripapillary atrophy, cold extremities) of participants were examined for association with the polymorphisms.

Results: A similar frequency of the polymorphic variants of the studied genes was observed in patients with NTG, HTG and control group. Initial intraocular pressure was the lowest in NTG patients with GG variant of rs1268656 (p = 0.044). The lowest maximal IOP in HTG patients was observed in CC variant of rs12154178 (p = 0.039). Patients with HTG and CC variant of ESR1 polymorphism rs1884054 had the best visual acuity (p = 0.009), similar tendency was also observed in the NTG group. This polymorphic variant of ESR1 gene in HTG was also related to earlier damage in visual field assessed according to MD values and higher percentage of notches. For rs12154178, homozygotic variant CC was related to earlier glaucoma damage according to MD in HTG patients (p = 0.006). For polymorphism rs12154178, disc hemorrhages were found only for those with the AC variant. Cold extremities were most frequent in NTG patients with TT variant of rs1268656 comparing to other variants (p = 0.021). Notches on optic disc were less frequent in patients with CC variant of rs12154178 of ERS-1 gene (p = 0.022).

Conclusions: The studied polymorphic variants of ESR1 and ESR2 genes may have an influence on the clinical phenotype of patients with POAG.     

Ex-PRESS引流器植入治疗原发性开角型青光眼的疗效

目的：观察Ex-PRESS青光眼引流器植入治疗原发性开角型青光眼的临床疗效。

方法：原发性开角型青光眼患者41例54眼分为研究组和对照组。研究组19例25眼,行Ex-PRESS青光眼引流器植入; 对照组22例29眼,行小梁切除术。比较两组患者平均手术时间、术后视力、浅前房、眼压、滤过泡及其他并发症的情况。

结果：研究组手术时间34.60±4.43min,术后1d浅前房1眼、前房出血1眼; 术后1wk高眼压2眼; 术后3mo视力下降1眼、功能性滤过泡24眼、眼压11.5±5.8mmHg。对照组手术时间44.37±3.00min,术后1d浅前房13眼、前房出血渗出12眼; 术后1wk高眼压8眼; 术后3mo视力下降6眼、功能性滤过泡25眼、眼压13.6±6.7mmHg。研究组术后并发症较少,眼压控制更低,术后视力影响、功能性滤过泡与对照组相当。

结论：Ex-PRESS青光眼引流器植入治疗原发性开角型青光眼手术时间缩短,术后浅前房、前房出血渗出并发症少,安全性高,疗效好。