微导管辅助小梁切开术治疗儿童青光眼的疗效

doi:10.3760/cma.j.cn115909-20210718-00284

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Abstract Objective: To investigate the clinical efficacy of ab externo microcatheter-assisted trabeculotomy (MAT) in childhood glaucoma and the open range of the incised trabecular meshwork one year after surgery. Methods: This was a prospective clinical study. 21 patients (28 eyes) with childhood glaucoma, aged 4-16 years, were enrolled in the glaucoma center of Henan Eye Hospital from January 2018 to December 2019. All patients underwent ab externo MAT. Patients were followed up for one year after surgery. The best corrected visual acuity (BCVA), intraocular pressure (IOP), usage of anti-glaucoma medication, the condition of the anterior chamber angle and complications were observed and analyzed. A paired t test, Wilcoxon signed-rank test, Kruskal-Wallis H test, and Spearman rank correlation were used to analyze the data. Results: All patients underwent ab externo MAT successfully. Surgery on 16 patients (22 eyes) was performed with full incisions and surgery on 5 patients (6 eyes) was performed with a subtotal incision. Preoperative BCVA (median: 0.8, range: 0.00-2.00) was not significantly different from postoperative BCVA (median: 0.75, range: 0.00-1.60) (Z=-1.41, P=0.157). Preoperative and postoperative IOPs were 30.4±4.8 mmHg (1 mmHg=0.133 kPa) and 14.1±4.5 mmHg, respectively. The difference was statistically significant (t=14.11, P<0.001). The amount of the postoperative anti-glaucoma medication (median: 0, range: 0-3) was significantly lower than preoperative levels (median: 3, range: 1-4) (Z=-4.35, P<0.001). At the last follow-up, the open range of the incised trabecular meshwork median was 302.5° (range: 70°- 360°). Fifteen cases (21 eyes) and 4 cases (5 eyes) achieved complete and qualified success; 2 cases (2 eyes) failed. The open range medians of the incised trabecular meshwork of the 3 groups were 330°(210°- 360°), 205°(180°-225°), and 85°(70°-100°) at the last visit. The open ranges of the different groups were statistically significant (χ2=15.20, P=0.001). The open range of incised trabecular meshwork was negatively correlated with intraocular pressure (r=-0.82, P<0.001). Conclusions: Ab externo MAT is effective for treating childhood glaucoma,and the postoperative open range of the incised trabecular meshwork is an important factor affecting the prognosis for children.

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ab externo microcatheter-assisted trabeculotomy glaucoma intraocular pressure anterior chamber angle childhood

Received: 18 July 2021

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Henan Health Sciencce and Technology Talents Overseas Research Project (HWYX2019123);

Henan Province Ministry Joint Construction Project (SBGJ2018072)

Corresponding Authors: Xiaoyuan Yang, Henan Eye Hospital, Henan Eye Institute, the People's Hospital of Henan Province, Zhengzhou 450000, China (Email: 13503892@qq.com)

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	Weiwei Liu1
	Xiaoyuan Yang2
	Conghui Ma2
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Cite this article:

Weiwei Liu1,Xiaoyuan Yang2,Conghui Ma2等. Clinical Efficacy of Ab Externo Microcatheter-Assisted Trabeculotomy in Childhood Glaucoma[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2022, 24(3): 221-226.

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20210718-00284 OR https://www.cjoovs.com/EN/Y2022/V24/I3/221

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