眼科

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微导管辅助的内路部分黏小管成形联合内路部分小梁切开术与内路全周小梁切开术的早期疗效对比

尹鹏  石砚  王一玮  王怀州  辛晨  曹凯  万月  王宁利   

  1. 首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 眼科学与视觉科学北京市重点实验室100005
  • 收稿日期:2019-04-20 出版日期:2020-07-22 发布日期:2020-07-21
  • 通讯作者: 王宁利,Email:wningli@vip.163.com
  • 基金资助:
    国家自然基金委-深圳机器人研究中心联合基金重点项目(U1713220)

Comparison of short-term efficacy of gonioscopy-assisted ab interno canaloplasty combined with transluminal trabeculotomy and standard gonioscopy-assisted transluminal trabeculotomy

Yin Peng, Shi Yan, Wang Yiwei, Wang Huaizhou, Xin Chen, Cao Kai, Wan Yue, Wang Ningli   

  1. Beijing Institute of Ophthalmology,  Beijing Tongren Eye Centre, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
  • Received:2019-04-20 Online:2020-07-22 Published:2020-07-21
  • Contact: Wang Ningli, Email: wningli@vip.163.com
  • Supported by:
    Key Projects of NSFC Shenzhen Robot Research Center Joint Fund (U1713220)

摘要: 目的 评估微导管辅助的内路部分小梁切开术联合内路部分黏小管成形术(简称GABiC)治疗原发性开角型青光眼(POAG)的疗效。设计 回顾性比较性病例系列。研究对象 2018年6月至2019年1月北京同仁医院18岁以上既往无其他抗青光眼手术史POAG患者30例(30眼)。方法 回顾行GABiC术与微导管辅助的内路360°小梁切开术(GATT)患者的病例资料,术后随访3个月。主要指标 眼压、降眼压药物用药情况、并发症、条件成功率、完全成功率。结果GABiC组7眼;GATT组23眼。术后3个月,GABiC组和GATT组眼压分别为17.0 ± 2.2 mmHg和14.7 ± 3.0 mmHg(P=0.081);用降眼压药物分别为(0.3±0.8)种、(0.1±0.4)种(P=0.865);绝对成功率分别为86% (6/7例)和83% (19/23例)(P=1.000);条件成功率分别为100% (7/7例)和96% (22/23例)(P=1.000)。术后眼压反弹分别为14%、48%(P=0.193),睫状体脱离分别为100%、100%,前房出血分别为57%、87%(P=0.120)。结论 短期随访结果显示,GABiC治疗POAG的效果和安全性与GATT无显著性差异。(眼科,2020,29: 304-308)

关键词: 内路360°, 小梁切开术;内路黏小管成形术;原发性开角型青光眼;微创青光眼手术

Abstract:  Objective To evaluate the efficacy of gonioscopy-assisted ab interno canaloplasty combined with transluminal trabeculotomy (GABiC) for primary open-angle glaucoma (POAG). Design retrospective comparative case series. Participants Thirty eyes of 30 POAG patients (18 years old or more) who has not any previous laser or surgical therapy were treated by the same surgeon from Tongren Eye Center from Jun 2018 to Jan 2019. Methods Retrospective review of patients who underwent GABiC or gonioscopy-assisted transluminal trabeculotomy (GATT) with 3 months follow-up. Main Outcome Measures IOP, medication use, complications, the rate of qualified success and complete success. Results 7 eyes in the GABiC group and 23 eyes in the GATT group. At 3 months, mean IOP was 17.0±2.2 mmHg for GABiC group and 14.7±3.0 mmHg for GATT group (P=0.081) on 0.3±0.8 and 0.1±0.4 medications(P=0.865), respectively. The absolute success rates were 86% (6/7 cases) for GABiC group and 83% (19/23 cases) for GATT group (P=1.000), and the qualified success rates were 100% (7/7 cases) for GABiC group and 96% (22/23 cases) for GATT group (P=1.000). The two groups had similar complications of IOP spike (GABiC 14%, GATT 48%; P=0.193), ciliary detachment (GABiC 100%, GATT 100%) and hyphema (GABiC 57%, GATT 87%; P=0.120). Conclusion Both surgeries were effective in reducing IOP and glaucoma medications safely. GABiC is a feasible surgical option for POAG. Further study with even longer follow-up is needed. (Ophthalmol CHN, 2020, 29: 304-308)

Key words: gonioscopy-assisted transluminal trabeculotomy, ab interno canaloplasty, primary open-angle glaucoma, microinvasive glaucoma surgery