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目的评价非穿透性小梁手术(NPTS)联合非吸收亲水丙烯酸假体(T-Flux)植入术治疗原发性开角型青光眼 (POAG)的中长期疗效及安全性。设计回顾性病例系列。研究对象 POAG患者85例(107眼)。方法对POAG患者行NPTS联合T-Flux植入术治疗,术后随访12-24个月,平均(18．7±5．0)个月。观察视力、眼压、滤过泡、前房深度及术后并发症等。主要指标视力、眼压、杯盘(C／D)比值、滤过泡、前房深度、术中及术后并发症。结果术后1年、1．5年、2年时术眼平均眼压分别为(17．9± 4．2)mmHg、(17．8±4.2)mmHg、(18．9±5．1)mmHg,与术前眼压(31．5±7．8)mmHg相比明显降低(P均<0．001);手术完全成功率分别为 86．9％、83.6％、79．6％;手术部分成功率分别为88．9％、86．5％、81．5％。手术成功与功能型滤过泡的形成和维持有明显关系,而与术中有无小梁网和狄氏膜微穿孔关系不大。并发症包括术中小梁网和狄氏膜穿孔、前房出血,术后早期低眼压、浅前房、脉络膜脱离等。结论 NPTS联合T-Flux植入术治疗POAG疗效显著,并发症少而轻。
Objective To evaluate the long-term and long-term efficacy and safety of non-penetrating trabecular meshwork (NPTS) and non-absorbent hydrophilic acrylic prosthesis (T-Flux) implantation in the treatment of primary open-angle glaucoma (POAG) Design retrospective case series. The study included 85 patients (107 eyes) with POAG. Methods POTS patients underwent NPTS combined with T-Flux implantation. The patients were followed up for 12-24 months with an average of (18.7 ± 5.0) months. Observation of visual acuity, intraocular pressure, filtration bleb, anterior chamber depth and postoperative complications. The main indicators of vision, intraocular pressure, cup plate (C / D) ratio, filtration bleb, anterior chamber depth, intraoperative and postoperative complications. Results The average intraocular pressure (IOP) at 1 year, 1.5 years and 2 years after operation were (17.9 ± 4.2) mmHg, (17.8 ± 4.2) mmHg and (18.9 ± 5.1) mmHg, which was significantly lower than preoperative intraocular pressure (31.5 ± 7.8) mmHg (all P <0.001). The complete success rates were 86.9%, 83.6% and 79.6% Part of the success rates were 88.9%, 86.5%, 81.5%. There was a clear relationship between the success of operation and the formation and maintenance of functional filtration bleb, but not with the intraoperative trabecular meshwork and Microtrac on the Dirschner membrane. Complications included intraoperative trabecular meshwork and peritoneal membrane perforation, anterior chamber hemorrhage, postoperative low intraocular pressure, shallow anterior chamber and choroidal detachment. Conclusion NPTS combined with T-Flux implantation for the treatment of POAG significant effect, less complications and light.