Schlemm管为基础的青光眼内引流手术术后眼压分布特征

doi:10.3760/cma.j.cn115909-20201020-00403

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摘要目的：分析以Schlemm管为基础的各类型青光眼内引流手术术后眼压分布特征。方法：回顾性系列病例研究。选取2015年6月至2019年1月于温州医科大学附属眼视光医院行以Schlemm管为基础的青光眼内引流手术（黏小管成形术和穿透性黏小管成形术）的患者资料，入选其中随访时间≥6个月，且末次随访在未用药情况下眼压≤21 mmHg（1 mmHg=0.133 kPa）患者，分析患者的眼压分布特征。各类型青光眼的眼压比较采用单因素方差分析。结果：共纳入患者204例（236眼），术前眼压为（33.4±12.1）mmHg，用药（2.7±1.2）种。术后末次随访时（6个月及以上）眼压为（13.9±3.3）mmHg。其中眼压分布在5～10 mmHg有37眼（15.7%），分布在>10～12 mmHg有43眼（18.2%），分布在 >12～15 mmHg有78眼（33.1%），分布在>15～18 mmHg有56眼（23.7%），分布在>18～21 mmHg有 22眼（9.3%）。原发性开角型青光眼（85眼）、原发性闭角型青光眼（30眼）、继发性青光眼（76眼）和先天性青光眼（45眼）的末次随访眼压分别为（13.9±3.2）（14.5±3.0）（14.0±3.3）（13.2±3.7）mmHg，各类型青光眼总体眼压差异无统计学意义（F=1.011，P=0.289）。对于原发性开角型青光眼，早、中、晚期青光眼的目标眼压达标率分别为82.4%、81.8%、36.8%。结论：以Schlemm管为基础的青光眼内引流手术术后平均眼压为14 mmHg，80%的早、中期以及1/3的晚期原发性开角型青光眼患者可以达到目标眼压。

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关键词 ： , Schlemm管, 青光眼, 内引流手术, 眼压分布

Abstract： Objective: To analyze the intraocular pressure (IOP) distribution characteristics after successful Schlemm's canal-based internal filtration surgery. Methods: In this retrospective series of case study, patients were collected from the Schlemm's canal-based surgery study (including canaloplasty and penetrating canaloplasty) in the Eye Hospital, Wenzhou Medical University during June 2015 to January 2019. Statistical analysis was carried out for those who met the inclusion criteria: Follow-up≥6 months and the postoperative IOP during the last follow-up was ≤21 mmHg (1 mmHg=0.133 kPa) without medication. IOP of different types were compared by one-way ANOVA. Results: A total of 204 patients (236 eyes) were enrolled in the statistical analysis. All 236 eyes had a mean preoperative IOP of (33.4±12.1)mmHg and mean glaucoma medication use of (2.7±1.2). Postoperative IOP data formed a normal distribution, with a mean IOP of (13.9±3.3)mmHg. There was no eye with an postoperative IOP below 5 mmHg. Postoperative IOP of patients with different types of glaucoma (primary open-angle glaucoma, primary angle-closure glaucoma, secondary glaucoma, and congenital glaucoma) all formed normal distribution, and the mean IOP were (13.9± 3.2)mmHg, (14.5±3.0)mmHg, (14.0±3.3)mmHg, and (13.2±3.7)mmHg, respectively, with no statistically significant difference between the groups (F=1.011, P=0.289). In primary open-angle glaucoma eyes, target IOP was achieved in 82.4% of early glaucoma, 81.8% moderate glaucoma and 36.8% advanced glaucoma. Conclusions: The average IOP after Schlemm's canal-based internal filtration surgery is about 14 mmHg. Target IOP is achieved in about 80% of eyes in primary openangle glaucoma with early-stage and moderate-stage and one-third of eyes with advanced stage.

Key words： Schlemm's canal glaucoma internal filtration surgery intraocular pressure distribution

收稿日期: 2020-10-20

PACS:

基金资助: 国家重点研发计划（2020YFC2008204）；浙江省高层次卫生创新人才计划（2016025）；浙江省高校领军人才培养计划（2020099）

通讯作者: 梁远波（ORCID：0000-0001-9685-7356），Email：yuanboliang@126.com

引用本文:

胡晶晶1 叶雯青1 唐艺华1 林海双1 古娟1 邓宇轩1 张绍丹1，2 梁远波1，2. Schlemm管为基础的青光眼内引流手术术后眼压分布特征[J]. 中华眼视光学与视觉科学杂志, 2021, 23(6): 409-413. Jingjing Hu1,Wenqing Ye1,Yihua Tang1,Haishuang Lin1,Juan Gu1,Yuxuan Deng1,Shaodan Zhang1, 2, Yuanbo Liang1, 2. The Distribution of Intraocular Pressure after Schlemm's Canal-Based Internal Filtration Surgery. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(6): 409-413. DOI: 10.3760/cma.j.cn115909-20201020-00403

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20201020-00403 或 https://www.cjoovs.com/CN/Y2021/V23/I6/409

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