XEN凝胶引流管植入术治疗晚期原发性青光眼的1年疗效观察

doi:10.13281/j.cnki.issn.1004-4469.2025.05.003

眼科 ›› 2025, Vol. 34 ›› Issue (5): 346-352.doi: 10.13281/j.cnki.issn.1004-4469.2025.05.003

XEN凝胶引流管植入术治疗晚期原发性青光眼的1年疗效观察

李秋梅王玮林赵瑞华毕会雯李绍伟

北京爱尔英智眼科医院，北京100021

收稿日期:2025-03-07 出版日期:2025-09-25 发布日期:2025-09-12
通讯作者: 李绍伟，Email： shaoweili2005@vip.163.com

One year clinical observation of XEN gel stent implantation for advanced primary glaucoma

Li Qiumei, Wang Weilin, Zhao Ruihua, Bi Huiwen, Li Shaowei

Beijing Aier-Intech Eye Hospital, Beijing 100021, China

Received:2025-03-07 Online:2025-09-25 Published:2025-09-12
Contact: Li Shaowei, Email: shaoweili2005@vip.163.com

摘要/Abstract

摘要： 目的研究XEN 凝胶引流管植入术治疗晚期原发性青光眼的1年疗效。设计回顾性病例系列。研究对象 2022年3月至2023年12月北京爱尔英智眼科医院连续行XEN凝胶引流管植入术的晚期原发性青光眼患者29例（33眼）。XEN组16例（19眼），Phaco联合XEN组 13例（14 眼）。方法回顾患者的病历资料。主要指标 视力、眼压、降眼压药物数量、手术成功率、术后并发症。结果所有患者术前眼压、降眼压药物数量、LogMAR视力分别为25.0（19.0，34.0）mmHg、4（3，4）种、0.4 （0.9，0.2），术后1年时眼压、平均眼压下降幅度、降眼压药物数量分别为13.0（11.0，16.0）mmHg、46.0%，0（0，0）种，手术成功率为80.7%（25/31）、LogMAR视力为0.3（1.0，0.1）。其中XEN组术前眼压、降眼压药物数量、LogMAR视力分别为26.0（19.0，30.0）mmHg、4（2，4）种、0.2（0.7，0.1），术后1年时眼压、平均眼压下降幅度、降眼压药物数量分别为13.0（10.0，15.0）mmHg、57.7%、0（0，2）种，手术成功率82.4%（14/17），LogMAR视力为0.3（0.7，0.1）。PhacoXEN组术前眼压、降眼压药物数量、LogMAR视力分别为24.5（19.9，32.0）mmHg、3.5（3，4）种、0.7（2.0，0.3），术后1年时眼压、平均眼压下降幅度、降眼压药物数量分别为13.0（12.0，16.0）mmHg、57.1%、0（0，0）种，手术成功率78.6%（11/14），LogMAR视力为0.3（1.0，0.2）。XEN组和PhacoXEN组术后1年手术成功率无统计学差异（χ2=0.45，P=0.9299）。所有患者术后发生前房出血12.1%（4/33），浅前房21.2%（7/33），脉络膜脱离12.1%（4/33），低眼压性黄斑病变、滤过泡炎各3.0%（1/33），均保守治疗恢复；术后滤过泡针拨占39.4%（13/33），其中PhacoXEN组滤过泡针拨率50%（7/14）明显高于XEN组31.5%（6/19），无引流管移位、暴露、眼内炎等并发症。结论本研究的小样本量1年随访结果显示，XEN引流管植入术治疗晚期原发性青光眼具有良好的疗效及安全性，XEN组及PhacoXEN组术后效果相当，但PhacoXEN组术后滤过泡针拨率更高。

关键词: 青光眼/外科学, XEN凝胶引流管

Abstract: Objective To evaluate the efficacy and safety of XEN gel stent implantation in the treatment of advanced primary glaucoma. Design Retrospective case series. Participants From March 2022 to December 2023, 29 patients (33 eyes) with advanced primary glaucoma underwent consecutive XEN gel drainage tube implantation in Beijing Aier-Intech Eye Hospital. There were 16 cases (19 eyes) in the XEN group and 13 cases (14 eyes) in the Phaco combined XEN group. Method The patient's medical records were reviewed. Main Outcome Measures Visual acuity, intraocular pressure (IOP), number of IOP-lowering drugs, surgical success rate, and postoperative complications. Results For all patients preoperative IOP，number of IOP-lowering medications and visual acuity (LogMAR) were 25.0 (IQR: 19.0, 34.0) mmHg, 4 (IQR: 3, 4) medications and 0.4 (IQR: 0.9, 0.2), respectively. At 1 year postoperatively, the IOP, mean IOP reduction, number of IOP-lowering medications, surgical success rate and visual acuity were 13.0 (IQR: 11.0, 16.0) mmHg, 46.0%, 0 (IQR: 0, 0) medications, 80.7% (25/31) and 0.3 (IQR: 1.0, 0.1), respectively. In the XEN group, preoperative IOP, number of IOP-lowering medications and visual acuity (LogMAR) were 26.0 (IQR: 19.0, 30.0) mmHg, 4 (IQR: 2, 4) and 0.2 (IQR: 0.7, 0.1), respectively. At 1 year postoperatively, the IOP, mean IOP reduction, number of IOP-lowering medications, surgical success rate and visual acuity (LogMAR) were 13.0 (IQR: 10.0,15.0) mmHg, 57.7%、0 (IQR: 0, 2) medications, 82.4% (14/17) and 0.3 (IQR: 0.7, 0.1) . In the PhacoXEN group, preoperative IOP, number of IOP-lowering medications, and visual acuity (LogMAR) were 24.5 (19.9, 32.0) mmHg, 3.5 (IQR: 3, 4) medications, and 0.7 (IQR: 2.0, 0.3), respectively. At 1 year postoperatively, the IOP, mean IOP reduction, number of IOP-lowering medications, surgical success rate, and visual acuity (LogMAR) were 13.0 (IQR: 12.0, 16.0) mmHg, 57.1%, 0 (IQR: 0, 0) medications, 78.6% (IQR: 11/14), and 0.3 (IQR: 1.0, 0.2), respectively. There was no statistically significant difference in the surgical success rate at 1 year between the XEN and PhacoXEN groups (χ2=0.45，P=0.9299). Complications included hyphema (12.1%, 4/33), shallow anterior chamber (21.2%, 7/33), choroidal detachment (12.1%, 4/33), hypotony maculopathy (3.0%, 1/33), and blebitis (3.0%, 1/33), all managed conservatively. Bleb needling was required in 39.4% (13/33) of cases, significantly higher in the PhacoXEN group (50%, 7/14) than in the XEN group (31.5%, 6/19). No complications such as stent migration, exposure, or endophthalmitis occurred. Conclusion The results of the one-year follow-up with a small sample size in this study show that XEN gel stent implantation demonstrates favorable clinical efficacy and safety in advanced primary glaucoma, with comparable outcomes between standalone and combined procedures. However, the PhacoXEN group exhibited a higher rate of postoperative bleb needling.

Key words: Glaucoma/surgery, XEN gel stent

李秋梅王玮林赵瑞华毕会雯李绍伟. XEN凝胶引流管植入术治疗晚期原发性青光眼的1年疗效观察[J]. 眼科, 2025, 34(5): 346-352.

Li Qiumei, Wang Weilin, Zhao Ruihua, Bi Huiwen, Li Shaowei. One year clinical observation of XEN gel stent implantation for advanced primary glaucoma[J]. Ophthalmology in China, 2025, 34(5): 346-352.

[1]	石砚钟红钰余晓伟范志刚. 恶性青光眼的诊疗进展及新认识[J]. 眼科, 2024, 33(3): 161-168.
[2]	尹瑞梅陈琳王涛. 改良的扁平部玻璃体放液用于青光眼白内障联合手术治疗伴晶状体悬韧带异常的闭角型青光眼的疗效观察[J]. 眼科, 2023, 32(5): 403-408.
[3]	周孟田朱树青李昊宇陈琪许淑霞, 解彦茜, 乐融融, 王小洁, 张绍丹, 梁远波, . 小梁切除术联合前房增殖膜拦截技术治疗新生血管性青光眼的有效性和安全性[J]. 眼科, 2023, 32(1): 21-26.
[4]	高妍辛晨石砚余晓伟范志刚. 改良式小梁切除联合深层巩膜切除术[J]. 眼科, 2022, 31(3): 175-180.
[5]	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.
[6]	程欢欢邓宇轩古娟张绍丹解彦茜乐融融叶聪梁远波王宁利. 国产眼科光纤导管在穿透性黏小管成形术中应用的六个月效果[J]. 眼科, 2019, 28(3): 182-185.
[7]	叶剑余玲. 青光眼白内障联合手术方式的选择与进展[J]. 眼科, 2019, 28(2): 81-85.
[8]	秦健翔解彦茜胡城王小洁梁远波. 针刺分离联合巩膜通道重建术治疗青光眼术后远期失败滤过泡[J]. 眼科, 2019, 28(1): 39-42.
[9]	梁远波程欢欢. 小梁切除术可以回归其内引流本质吗?[J]. 眼科, 2018, 27(6): 401-403.
[10]	张秀兰李飞. 未来青光眼手术路在何方？[J]. 眼科, 2018, 27(1): 1-3.
[11]	侯旭胡丹崔志利周健蔡莉王雨生. 微创小梁切除联合晶状体超声乳化术治疗急性闭角型青光眼合并白内障的6个月效果[J]. 眼科, 2015, 24(1): 31-35.
[12]	陈燕云范肃洁梁远波荣世松孟海林王星王宁利. 有无急性发作史的慢性闭角型青光眼患者小梁切除术18个月效果比较[J]. 眼科, 2014, 23(6): 388-391.
[13]	郭文毅郭春雨. 儿童青光眼诊断与治疗中的几个问题[J]. 眼科, 2014, 23(5): 357-360.
[14]	段宣初罗昊敏. 抗青光眼手术的利与弊[J]. 眼科, 2014, 23(4): 288-288.
[15]	黄瑶, 荣世松, 孟海林, 范素洁, 李思珍, 梁远波, 王宁利. 小梁切除术术中房水滤过量与术中及术后早期眼压无关[J]. 眼科, 2014, 23(2): 94-98.

XEN凝胶引流管植入术治疗晚期原发性青光眼的1年疗效观察

One year clinical observation of XEN gel stent implantation for advanced primary glaucoma

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价