青光眼EXPRESS引流钉植入术的并发症分析

目的 对青光眼EXPRESS引流钉植入术的并发症进行分析,探讨原因及解决方法. 方法 回顾性分析2013年9月至2016年3月在解放军第180医院眼科行EXPRESS引流钉植入术的开角型青光眼患者39例(54眼)临床资料,记录分析术中、术后并发症情况. 结果 术中并发症2眼:1眼EXPRESS引流钉从植入器脱落,改用显微镊植入;1眼前房穿刺时隧道倾斜,放弃原隧道另外再做一穿刺隧道.术后并发症15眼:术后早期2级浅前房7眼,其中1眼合并前房出血;脉络膜脱离1眼;引流钉位置偏后5眼,其中3眼引流钉接触虹膜;引流钉位置偏前1眼;引流钉暴露1眼.2眼行引流钉取出,改为小梁切除术. 结论 EXPRESS引流钉植入术除了可引起与小梁切除术相同的并发症外,还存在引流钉独有的并发症,需引起重视.

The analysis of the complication of EXPRESS glaucoma drainage device implantation

Objective To analyze the complications of EXPRESS glaucoma drainage implantation and treatment. Methods A total of 39 patients (54 eyes) with open-angle glaucoma were recruited which had EXPRESS implantation between November, 2013 and March, 2016. Record and analyze the complications. Results Two cases had operative complications. The EXPRESS dropped accidently from the implant in one patient. It was re-implanted with micro-forceps. The tunnel inclined when puncturing into the anterior chamber in another patient. The old tunnel was abandoned and a new tunnel was made. There were 15 cases that had post-operative complications. Seven patients suffered from grade II shallow anterior chamber early after operation, in which hyphema was found in one patient. Another patient met with choroid detachment. The position of EXPRESS was too posterior in 5 cases and touched iris in 3 patients. In 1 patient it located too anteriorly. And one case got exposure 7 months after surgery. Two eyes underwent EXPRESS taken out and new trabeculectomy were operated. Conclusion EXPRESS glaucoma drainage implantation shares the same complications with trabeculectomy. Moreover, it owns some unique complications and should raise clinician`s concern.