无黏弹剂扩张的穿透性Schlemm管成形术治疗原发性开角型青光眼的1年疗效观察

doi:10.13281/j.cnki.issn.1004-4469.2024.01.003

眼科 ›› 2024, Vol. 33 ›› Issue (1): 16-20.doi: 10.13281/j.cnki.issn.1004-4469.2024.01.003

无黏弹剂扩张的穿透性Schlemm管成形术治疗原发性开角型青光眼的1年疗效观察

刘雅聪周文宗梁四妥孙军赵华吴鑫桐王亚莉李希炜

沧州爱尔眼科医院，河北沧州 061000

收稿日期:2023-10-17 出版日期:2024-01-25 发布日期:2024-02-06
通讯作者: 周文宗，Email：zonggehi@126.com
基金资助:
河北省沧州市重点研发计划指导项目（213106140）

One year efficacy of penetrating canaloplasty without viscoelastic for primary open-angle glaucoma

Liu Yacong, Zhou Wenzong, Liang Situo, Sun Jun, Zhao Hua, Wu Xintong, Wang Yali, Li Xiwei

Cangzhou Aier Eye Hospital, Cangzhou Hebei 061000, China

Received:2023-10-17 Online:2024-01-25 Published:2024-02-06
Contact: Zhou Wenzong, Email: zonggehi@126.com
Supported by:
Key R & D Plan Guidance Project in Cangzhou City, Hebei Province (213106140)

摘要/Abstract

摘要： 目的观察无黏弹剂扩张的穿透性Schlemm管成形术对原发性开角型青光眼（POAG）的疗效和安全性。设计前瞻性病例系列研究。研究对象 2021年12月至2022年6月在沧州爱尔眼科医院行无黏弹剂扩张的穿透性Schlemm管成形术治疗的POAG患者25 例（35眼）。方法记录术前术后眼压、抗青光眼药物数量、术前及术后1年LogMAR 最佳矫正视力（BCVA）、视网膜神经纤维层（RNFL）平均厚度、垂直C/D、黄斑区平均节细胞层（GCL）厚度、术中及术后并发症等。术后1、7天，1、3、6个月，1年随访。术后不使用任何降眼压药物，眼压≤21 mmHg为完全成功；使用降眼压药物（2种以内），眼压≤21mmHg为条件成功。主要指标 Schlemm管穿通率、眼压、手术成功率、术中术后并发症。结果 33眼（94.3%）完成无黏弹剂扩张的360°Schlemm管穿通。所有患者均完成了12个月随访，术前平均眼压（25.8±7.7）mmHg，术后1、7天，1、3、6个月，1年的眼压分别为（14.1±6.1）、（13.3±4.9）、（14.8±4.4）、（15.0±4.8）、（15.2±4.0）和（14.7±3.6）mmHg，术前与术后比较，差异均有统计学意义（P均<0.001）。术后1年手术完全成功率和条件成功率分别为 90.9 %（30/33）和 97.0%（32 /33）。结论无黏弹剂扩张的穿透性Schlemm管成形术治疗POAG安全有效，短期降眼压疗效显著。（眼科，2024, 33： 16-20）

关键词: 无黏弹剂扩张, 穿透性Schlemm管成形术, 原发性开角型青光眼

Abstract: Objective To observe the efficacy and safety of penetrating canaloplasty without viscoelastic for primary open angle glaucoma (POAG). Design Prospective case series. Participants 25 patients (35 eyes) with POAG penetrating canaloplasty without viscoelastic at Cangzhou Aier Eye Hospital from December 2021 to June 2022 were treated. Methods Record preoperative and postoperative intraocular pressure (IOP), number of anti-glaucoma drugs, LogMAR best corrected visual acuity (BCVA), average retinal nerve fiber layer (RNFL) thickness, vertical C/D, average gangline cell layer (GCL) thickness in the macular area, intraoperative and postoperative complications. Time points of follow-up were arranged at 1 day, 7 days, 1 month, 3 months, 6 months, and 1 year after the surgery. Complete success was defined as IOP ≤21 mmHg without any glaucoma medications. Qualified success was defined as IOP≤21 mmHg with glaucoma medications (within 2 types). Main Outcom Measures Rate of circumferential catheterization of the canal, IOP, surgical success rate, and intraoperative and postoperative complications. Results 33 eyes (94.3%) achieved the 360 degrees’catheterization of the canal without viscoelastic. All patients completed a 12 month follow-up, with an average preoperative IOP of (25.8±7.7) mmHg. The postoperative IOP at 1 day, 7 days, 1 month, 3 months, 6 months, and 1 year were (14.1±6.1), (13.3±4.9), (14.8±4.4), (15.0±4.8), (15.2±4.0) and (14.7±3.6) mmHg, respectively. There were statistically significant differences between the preoperative and postoperative IOP (all P<0.001). The complete success rate and qualified success rate at 1 year after surgery were 90.9% (30/33) and 97.0% (32/33), respectively. Conclusion The penetrating canaloplasty without viscoelastic is safe and effective for the treatment of POAG. Which has a significant short-term effect on reducing IOP. (Ophthalmol CHN, 2024, 33: 16-20)

Key words: expansion without viscoelastic, penetrating canaloplasty, primary open-angle glaucoma

刘雅聪周文宗梁四妥孙军赵华吴鑫桐王亚莉李希炜. 无黏弹剂扩张的穿透性Schlemm管成形术治疗原发性开角型青光眼的1年疗效观察[J]. 眼科, 2024, 33(1): 16-20.

Liu Yacong, Zhou Wenzong, Liang Situo, Sun Jun, Zhao Hua, Wu Xintong, Wang Yali, Li Xiwei . One year efficacy of penetrating canaloplasty without viscoelastic for primary open-angle glaucoma[J]. Ophthalmology in China, 2024, 33(1): 16-20.

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无黏弹剂扩张的穿透性Schlemm管成形术治疗原发性开角型青光眼的1年疗效观察

One year efficacy of penetrating canaloplasty without viscoelastic for primary open-angle glaucoma

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