非穿透性小梁手术联合醛化脐带静脉管植入及MMC治疗POAG

目的:评价非穿透性小梁手术(non-penetrating trabecular surgery,NPTS)联合醛化脐带静脉管(human umbilical vein,HUV)植入和丝裂霉素C(mitomycin C,MMC)治疗原发性开角型青光眼(primary open angle glaucoma,POAG)的临床疗效。方法:对42例42眼POAG患者进行NPTS联合HUV植入和MMC治疗。术后观察指标包括:术后眼压、术后抗青光眼药物应用、术后滤过泡形态学以及术后并发症,随访时间12mo。结果:术后12 mo,手术完全成功81%,条件成功95%;眼压从术前(26.1±7.7)mmHg降至(15.3±3.8)mmHg(P=0.00);抗青光眼药物从术前(3.2±0.5)种减少到(0.3±0.2)种(P=0.00);滤过泡形态,Ⅰ型滤过泡26%,Ⅱ型滤过泡59%,Ⅳ型滤过泡14%。术后6眼出现包裹性滤过泡,3眼有轻微前房出血,无浅前房、低眼压和脉络膜脱离等并发症发生。结论:NPTS联合HUV植入和MMC治疗POAG,具有手术成功率高,术后IOP控制良好,术后并发症发生率低的特点。

Clinical effect of non-penetrating trabecular surgery with human umbilical vein implant and mitomycin C for treatment of primary open angle glaucoma

AIM:To evaluate the clinical effect of non - penetrating trabecular surgery(NPTS) with human umbilical vein (HUV) implant and mitomycin C(MMC) in patients with primary open angle glaucoma(POAG). METHODS:NPTS with HUV implant and MMC was performed on 42 eyes of 42 patients with POAG.The outcome’s evaluation included postoperative intraocular pressure(IOP),number of anti-glaucoma medications,the morphologic characteristics of the filtering blebs and complications.All patients were followed up for 12 months. RESULTS:The postoperative complete success rate was 81%and qualified success rate was 95%at 12 months after surgery respectively;IOP was decreased from(26.1±7.7) mmHg to(15.3±3.8) mmHg at 12 months(P = 0.00);the number of anti-glaucoma medications was decreased from(3.2±0.5) to(0.3±0.2) at 12 months(P = 0.00);the morphologic characteristics of the filtering blebs:typeⅠwas 26%,typeⅡwas 59%,typeⅣwas 14%. Encapsulated bleb was observed in 6 eyes and there was a small amount of hyphema that was absorbed in 3 eyes, but the complications such as flat chamber,hypotony and choroidal effusion were not observed. CONCLUSIONS:NPTS with HUV implant and MMC might improve the clinical outcome of the patients with POAG,such as higher success rates,lower postoperative mean IOP,and less complication rates.