穿透性Schlemm管成形术远期效果的初步观察

doi:10.13281/j.cnki.issn.1004-4469.2022.01.003

眼科 ›› 2022, Vol. 31 ›› Issue (1): 14-19.doi: 10.13281/j.cnki.issn.1004-4469.2022.01.003

穿透性Schlemm管成形术远期效果的初步观察

叶雯青古娟胡城程欢欢邓宇轩张绍丹解彦茜乐融融梁远波

温州医科大学附属眼视光医院温州医科大学青光眼研究所国家眼部疾病临床医学研究中心，温州 325027 （胡城现在解放军中部战区总医院，武汉430064；程欢欢现在芜湖市第一人民医院，芜湖241060；邓宇轩现在青岛市市立医院(集团)眼科中心，青岛 266011）

收稿日期:2021-11-24 出版日期:2022-01-25 发布日期:2022-01-18
通讯作者: 梁远波，Email：yuanboliang@126.com
基金资助:
国家重点研发计划（2020YFC2008200）；浙江省卫生高层次创新人才计划（2016025）

The preliminary study on long-term efficacy of penetrating canaloplasty in glaucoma

Ye Wenqing, Gu Juan, Hu Cheng, Cheng Huanhuan, Deng Yuxuan, Zhang Shaodan, Xie Yanqian, Le Rongrong, Liang Yuanbo

The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Glaucoma Research Institute, Wenzhou Medical University; National Clinical Research Center for Ocular Diseases, Wenzhou 325027, China (Hu Cheng is now working at the Department of Ophthalmology, Wuhan General Hospital of PLA, Wuhan 430064, China; Cheng Huanhuan is now working at Wuhu First People’s Hospital, Wuhu 241060, China; Deng Yuxuan is now working at Qingdao Municipal Hospital, Qingdao 266011, China)

Received:2021-11-24 Online:2022-01-25 Published:2022-01-18
Contact: Liang Yuanbo, Email: yuanboliang@126.com
Supported by:
National Key Research and Development Project (2020YFC2008200)； Zhejiang Province High-level Innovative Talents Plan of Heath (2016025)

摘要/Abstract

摘要： 目的观察穿透性Schlemm管成形术治疗青光眼的远期疗效。设计回顾性病例系列。研究对象 2015年6~12月于温州眼视光医院行穿透性Schlemm管成形术的连续青光眼病例15例（16眼）。方法回顾患者术前基本资料、术后眼压及降眼压药物数量等信息。手术成功定义为术后眼压≤21 mmHg；其中未使用任何降眼压药物者为完全成功，无论是否使用降眼压药物则为条件成功。主要指标 眼压、抗青光眼药物数量、手术成功率、手术并发症及术后滤过泡形态。结果 15例（16眼）中男性7例，平均年龄（48.9±16.0）岁。术前眼压为（37.9±11.4）mmHg，平均用药3种（2，4种）。术后1个月、3个月、6个月、1年、2年、3年、4年、5年的平均眼压分别为（17.2±6.0）、（15.9±4.5）、（14.4±2.2）、（13.0±1.8）、（13.7±3.2）、（12.9±2.9）、（15.6±3.1）、（14.5±2.7）mmHg，术后各时间点与术前眼压的差异均具有统计学意义。术后1个月的降眼压药物数量的中位数（范围）为0（0，1.5），术后3个月、6个月、1年、2年、3年、4年、5年的降眼压药物数量均为0种，术前术后用药的差异均具有统计学意义。术后3年及5年累积完全成功率均为81.3%。11眼（68.8%）出现术后并发症，以术后短暂性高眼压（43.8%）及前房积血（37.5%）为主。13眼（81.3%）未见明显滤过泡。结论穿透性Schlemm管成形术是治疗青光眼的一种新的内引流方式，初步结果显示其远期疗效高且稳定，但仍需要更大样本病例的远期疗效观察。（眼科， 2022， 31： 14-19）

关键词: 青光眼/外科学, 穿透性Schlemm管成形术

Abstract: Objective To evaluate the long-term efficacy and safety of penetrating canaloplasty for glaucoma. Design Retrospective case series. Participants Consecutive cases of 15 glaucoma patients (16 eyes) with penetrating canaloplasty at the Eye Hospital of Wenzhou Medical University from June 2015 to December 2015 were collected. Methods The preoperative demographic characteristics and postoperative intraocular pressure (IOP), glaucoma medications and other information were reviewed. Surgical success was defined as IOP ≤21 mmHg with or without glaucoma medications (qualified success) and without any glaucoma medications (completes success). Main Outcome Measures IOP, number of glaucoma medications, surgical success rate, complications and filtering bleb status. Results A total of 15 glaucoma patients (16 eyes) achieved the successful 360-degree catheterization of the canal with 7 males which were included to analyze. The mean age was (48.9±16.0) years old, and the mean preoperative IOP was (37.9±11.4) mmHg with the median medication number of 3 (2, 4). The mean postoperative IOP was (17.2±6.0), (15.9±4.5), (14.4±2.2), (13.0±1.8), (13.7±3.2), (12.9±2.9), (15.6±3.1), and (14.5±2.7) mmHg at 1 month, 3 months, 6 months, 12 months, 24 months, 36 months, 48 months, 60 months, respectively. There was significant difference in IOP between postoperative and preoperative. The median medication number (range) was 0 (0, 1.5) at 1 month and 0 at the rest follow-up time, respectively. There was significant difference in the number of medications between postoperative and preoperative. The complete success rate at 36 months and 60 months were both 81.3%. Intraoperative and postoperative complications were observed in 11 eyes (68.8%) of 16 eyes, mainly including IOP spike (43.8%) and hyphema (37.5%). 13 eyes (81.3%) had no obvious filtering bleb. Conclusions The penetrating canaloplasty is a new internal drainage surgery for glaucoma with stable long-term efficacy, but need to be observed in a larger sample. (Ophthalmol CHN, 2022, 31: 14-19)

Key words: glaucoma/surgery, penetrating canaloplasty

叶雯青古娟胡城程欢欢邓宇轩张绍丹解彦茜乐融融梁远波. 穿透性Schlemm管成形术远期效果的初步观察[J]. 眼科, 2022, 31(1): 14-19.

Ye Wenqing, Gu Juan, Hu Cheng, Cheng Huanhuan, Deng Yuxuan, Zhang Shaodan, Xie Yanqian, Le Rongrong, Liang Yuanbo. The preliminary study on long-term efficacy of penetrating canaloplasty in glaucoma [J]. Ophthalmology in China, 2022, 31(1): 14-19.

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[15]	陈霄雅, 王怀洲, 王宁利. 微创青光眼手术新进展[J]. 眼科, 2014, 23(1): 64-68.

穿透性Schlemm管成形术远期效果的初步观察

The preliminary study on long-term efficacy of penetrating canaloplasty in glaucoma

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