外路微导管辅助的360度小梁切开术治疗青少年性开角型青光眼和原发性开角型青光眼的临床对照研究

目的 评估微导管辅助小梁切开术治疗青少年性开角型青光眼（JOAG）和原发性开角型青光眼（POAG)的临床效果和安全性。设计 回顾性病例系列。研究对象2017年11月至2018年12月北京同仁医院接受微导管辅助的小梁切开术治疗的JOAG患者22例（26眼），平均年龄（25.2±4.5）岁；POAG患者11例（14眼），平均年龄（46.3±5.1）岁。方法 回顾患者的病历资料，记录眼压、抗青光眼药物使用数量、术中及术后并发症等。术后1、3、6、12个月随访。术后不使用降眼压药物眼压≤21 mmHg且眼压下降幅度≥20%为成功。主要指标 眼压、抗青光眼药物使用数量、术中及术后并发症。结果 所有患者均完成了12个月的随访。JOAG组术前平均眼压（30.6±7.5） mmHg，平均应用（3.5±1.0）种药物；术后12个月平均眼压（15.8±3.3 ) mmHg，平均应用（0.5±1.0）种药物，眼压降幅为44.9%±18.0%。POAG组术前平均眼压（25.4±6.2） mmHg，平均应用（3.4±0.9）种药物；术后12个月平均眼压（15.9±3.2） mmHg，平均应用（0.3±0.6）种药物，眼压降幅为35.8%±15.6%。JOAG组、POAG手术成功率分别为76.0%、78.6%。两组降眼压幅度和成功率均无显著性统计学差异（P=0.122、0.855)。均无严重手术并发症发生。结论 微导管辅助小梁切开术治疗JOAG和POAG均具有较好的短期降眼压效果及安全性。（眼科，2021， 30： 20-24）

Comparison of the efficacy and safety of ab externo microcatheter-assisted trabeculotomy for juvenile open-angle glaucoma and primary open angle glaucoma

Objective To evaluate the efficacy and safety of ab externo microcatheter-assisted trabeculotomy(MAT)for the surgical management of juvenile open angle glaucoma(JOAG)and primary open angle glaucoma(POAG).Design Retrospective case series.Participants Consecutive 22 patients(26 eyes)with JOAG with mean age 25.2±4.5 years old and 11patients(14 eyes)with POAG with mean age 46.3±5.1 years old underwent ab externo MAT between November 2017 and December 2018 by a single surgeon in Beijing Tongren Eye Center.Methods The patient's medical records were reviewed.Patients were followed before and 1,3,6,12 months after surgery.Surgical success was defined as a postoperative IOP of≤21 mmHg and decreased more than 20%from baseline without the use of anti-glaucoma medication.Main Outcome Measures Intraocular pressure(IOP),number of anti-glaucoma medication,surgical complications.Results All cases fulfilled 12 months follow-up.The mean age of JOAG group was 25.2±4.5 years old,the mean age of POAG group was 46.3±5.1 years old.The preoperative IOP was 30.6±7.5 mmHg in JOAG group,which was much higher than that in POAG group(25.4±6.2 mmHg,P=0.035).The overall IOP reduction was 44.9±18.0%from 30.6±7.5 mmHg to 15.8±3.3 mmHg at 12 months in JOAG group(P<0.01).For POAG group,the IOP reduction was 35.8±15.6%from 25.4±6.2 mmHg to 15.9±3.2 mmHg at 12 months in POAG group(P<0.01).The number of topical medication decreased dramatically after surgical procedures in both groups(P<0.01).The overall complete success rate was similar between the two groups,76.0%for JOAG and 78.6%for POAG(P=0.855).There was no severe complications occurred in both groups.Conclusion Ab externo MAT is same effective and safe surgical option both JOAG and POAG.(Ophthalmol CHN,2021,30:20-24)