Ex-press青光眼引流钉植入术治疗难治性青光眼的疗效分析

目的:探讨Ex-press青光眼引流钉植入术治疗难治性青光眼的临床疗效与安全性.方法:回顾性分析行Ex-press青光眼引流钉植入术治疗的难治性青光眼患者22例23眼.观察术前及术后1wk,1、2、3、6mo,1a的视力、眼压及并发症发生情况.结果:所有患者均随访至1a.完全成功率为52％(12眼),部分成功率22％(5眼),总成功率74％.术前平均眼压为40.59±11.11mmHg(1mmHg=0.133kPa),术后1wk,1、2、3、6mo,1a的平均眼压分别为10.30±5.07、12.23±4.03、13.87±4.62、16.52±6.09、18.35 ±7.06、19.65±8.26mmHg.术后各时间点眼压与术前眼压相比均有统计学意义(P＜0.01).术后患者视力较术前提高,差异有统计学意义(P＜0.01).23眼中3眼出现少量前房出血,分别于术后4 ～7d自行吸收;2眼出现一过性低眼压,密切观察8～10d后眼压＞6mmHg;1眼术后1mo出现渗出性脉络膜脱离,给予局部使用激素后于术后37d复位.所有患者均未出现其他并发症.结论:Ex-press青光眼引流钉植入术治疗难治性青光眼安全有效.

Clinical effect of Ex-press glaucoma value implantation for the treatment of refractory glaucoma

AIM: To explore the safety and efficacy of Ex-press glaucoma value implantation for the treatment of refractory glaucoma.

METHODS:The data of 22 patients(23 eyes)with refractory glaucoma received implantation of Ex-press glaucoma value were retrospectively analyzed. The visual acuity, intraocular pressure(IOP)and complications in all patients were observed before and after operation in 1wk, 2mo, 3mo, 6mo and 12mo.

RESULTS:All patients were followed up for 1y. The complete success rate was 52%(12 eyes), the partial success rate was 22%(5 eyes)and the total success rate was 74%. The IOP of preoperative and postoperative 1wk, 1mo, 2mo, 3mo, 6mo, and 12mo was 40.59±11.11, 10.30±5.07, 12.23±4.03, 13.87±4.62, 16.52±6.09, 18.35±7.06 and 19.65±8.26 mmHg,(1mmHg=0.133 KPa)respectively. Postoperative IOP at every time point was significantly decreased compare to preoperation(P<0.01). The visual acuity was significantly improved postoperatively(P<0.01). Postoperative hyphema were found in 3 eyes, transient low IOP in 2 eyes, and choroids detachment in 1 eye. All of these complications appeared at the early postoperative stage and healed within 4-14d. No other complications were observed.

CONCLUSION:Ex-press glaucoma value implantation seemed to be one of the most safe and effective way in treatment of refractory glaucoma.