[1]李海军,任静,杨潇远,等.内路房角镜辅助经管腔内小梁切开术治疗多次手术开角型青光眼患者的疗效观察[J].眼科新进展,2021,41(8):732-736.[doi:10.13389/j.cnki.rao.2021.0152]
　LI Haijun,REN Jing,YANG Xiaoyuan,et al.Outcome of gonioscopy-assisted transluminal trabeculotomy in open angle glaucoma patients[J].Recent Advances in Ophthalmology,2021,41(8):732-736.[doi:10.13389/j.cnki.rao.2021.0152]
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内路房角镜辅助经管腔内小梁切开术治疗多次手术开角型青光眼患者的疗效观察/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年8期
页码:
732-736
栏目:
应用研究
出版日期:
2021-08-05

文章信息/Info

Title:
Outcome of gonioscopy-assisted transluminal trabeculotomy in open angle glaucoma patients
作者:
李海军; 任静; 杨潇远; 董良; 刘茜
450000　河南省郑州市，河南省眼科研究所、河南省人民医院、河南眼科临床研究中心
Author(s):
LI Haijun;  REN Jing;  YANG Xiaoyuan;  DONG Liang;  LIU Qian
Henan Eye Institute & Henan Provincial Eye Hospital, Henan Provincial People’s Hospital, Zhengzhou 450000, Henan Province, China
关键词:
房角镜辅助经管腔内小梁切开术; 开角型青光眼; 眼压
Keywords:
gonioscopy-assisted transluminal trabeculotomy;  open angle glaucoma;  intraocular pressure
分类号:
R775
DOI:
10.13389/j.cnki.rao.2021.0152
文献标志码:
A
摘要:
目的　评价内路房角镜辅助经管腔内小梁切开术（GATT）治疗多次手术开角型青光眼（OAG）患者的临床疗效和安全性。方法　回顾性病例研究。共纳入OAG患者57例(57眼)，按手术治疗史分为初次手术组［18例（18眼）］和多次手术组［39例（39眼）］，均予以GATT治疗,术后随访至少1年。记录术前及术后1年内各随访时间点的眼压、使用的降眼压药物数量及术中、术后并发症，并分析手术成功率。结果　术后12个月时，初次手术组患者眼压由术前的(32.12±4.14)mmHg（1 kPa=7.5 mmHg）降低至(18.23±2.88)mmHg，多次手术组患者眼压由术前的（33.49±4.78）mmHg降低至（18.51±6.62）mmHg，各随访时间点患者眼压同基线平均眼压相比，差异均有统计学意义（均为P<0.05）,两组患者间不同时间点眼压相比差异均无统计学意义（均为P>0.05）。术后12个月，初次手术组、多次手术组患者完全成功率分别为55.6%、 38.5%，条件成功率分别为22.2%、 20.5%，失效率分别为22.2%、 41.0%，两组患者间成功率比较，差异无统计学意义（Z=-1.404，P=0.160），完全成功累积生存率分别为44.4%、 38.5%（χ2=0.364,P=0.546），条件成功累积生存率分别为77.8%、57.1%（χ2=1.534,P=0.215）。初次手术组患者使用抗青光眼药物种类由术前的3.00［3，4］种减少为0.00［0，2］种，多次手术组患者使用抗青光眼药物种类由术前的2.75［3，4］种减少为1.10［1，2］ 种（Z=-2.080，P=0.037）。两组患者术后并发症均以前房积血为主，一过性眼压升高次之，均无严重并发症发生。结论　GATT是初次手术与多次手术OAG患眼的有效治疗方式，术后并发症以短暂性前房积血与一过性眼压增高为主，无严重并发症发生。
Abstract:
Objective　To evaluate the safety and efficacy of gonioscopy-assisted transluminal trabeculotomy (GATT) in open-angle glaucoma (OAG) patients.Methods　This paper is based on a retrospective study. A total of 57 OAG patients (57 eyes) were classified into the primary surgery group ［18 cases (18 eyes)］ and repeated surgery group ［39 cases (39 eyes)］. All these cases had undergone the GATT and received one-year follow-up examinations after the surgery. The intraocular pressure (IOP), number of IOP-lowering medications, intraoperative and postoperative complications were recorded respectively before the surgery and during the one-year follow-up period, and the success rate of surgery was analyzed.Results　At the last follow-up examination, the IOP of patients in the primary surgery group was reduced from the preoperative (32.12±4.14) mmHg (1 kPa=7.5 mmHg) to the postoperative (18.23±2.88) mmHg, and the IOP of patients in the repeated surgery group was reduced from the preoperative (33.49±4.78) mmHg to the postoperative (18.51±6.62) mmHg. The difference between the IOP at each follow-up examination and the average IOP baseline was statistically significant (all P<0.05), while the difference between the two groups was not statistically significant (all P>0.05). Twelve months after surgery,the complete success rate in the primary surgery group and repeated surgery group was 55.6% vs 38.5%, the qualified success rate was 22.2% vs 20.5%, and the failure rate was 22.2% vs 41.0% (Z=-1.404, P=0.160). The cumulative probability of complete success was 44.4% vs 38.5% (χ2=0.364, P=0.546), and that of qualified success was 77.8% vs 57.1% (χ2=1.534, P=0.215). The type of IOP-lowering medications was postoperatively reduced from 3.00［3,4］ to 0.00［0,2］ in the primary surgery group, and from 2.75［3,4］ to 1.10［1,2］ in the repeated surgery group (Z=-2.080, P=0.037). Mild hyphema and transient IOP spike occurred in both groups, but no severe complication was found.Conclusion　GATT is an effective therapy for patients with OAG and causes no severe complications in the primary or repeated surgery except transient hyphema and IOP spike.

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备注/Memo

备注/Memo:
国家自然科学基金项目（编号：U1904166）；河南省省部共建项目（编号：SBGJ2018072）
更新日期/Last Update: 2021-08-05