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伪剥皮眼镜中深层结膜切除术的五年结果与初级开角眼镜相比

Carlo Fiore¹, Xiao Shang^1,2, Joel-Benjamin Lincke¹

¹Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland.

Journal of clinical medicine

|December 17, 2024

概括

深度硬膜切除术 (DS) 对伪剥离型玻璃眼 (PEXG) 和初级开角玻璃眼 (POAG) 患者的眼内压力和视网膜神经纤维层厚度产生了类似的影响. 然而,PEXG患者的手术成功率较低,并且在五年内需要更多的干预.

科学领域:

眼科医生眼科眼科
玻璃眼的手术玻璃眼的手术
视网膜成像视网膜成像

背景情况:

伪剥离性眼光障碍 (PEXG) 和初级开角眼光障碍 (POAG) 是不可逆转失明的主要原因.
深度硬膜切除术 (DS) 是治疗青光眼的一种手术选择.
长期来看,PEXG与POAG中DS的比较结果并未得到很好的确立.

研究的目的:

为了比较诊断为伪剥皮绿内障 (PEXG) 和初级开角绿内障 (POAG) 的患者的深度硬内障切除术 (DS) 的五年临床结果.
为了评估DS在控制眼内压力 (IOP) 和保持视网膜神经纤维层 (RNFL) 厚度的有效性,在两种青光眼子类型中.

主要方法:

追溯性,观察性,单心研究,包括109个POAG眼睛和153个PEXG眼睛.
评估眼内压力 (IOP),药物使用,周囊RNFL厚度,术后干预和手术成功率在5年的随访期间.
统计分析以比较POAG和PEXG队列之间的结果.

主要成果:

POAG和PEXG两组都显示出显著的IOP降低和DS后药物使用减少 (p < 0.001).
在两组人群中,在五年内,周周膜RNFL的厚度都下降了 (p < 0.001).
五年完全成功率为POAG的33%和PEXG的12% (p = 0.01);合格的成功率为POAG的63%和PEXG的40% (p = 0.03).
在8%的POAG眼睛中,需要进行二次玻璃眼瘤手术,而在PEXG眼睛中,这一比例为21% (p = 0.04).

结论:

深度硬膜切除术在五年内在PEXG和POAG患者中产生了可比的IOP控制和RNFL保存.
与POAG患者相比,PEXG患者的DS与较不有利的外科成功率和更高的需要进行随后的玻璃眼手术有关.
这些发现突出了PEXG和POAG之间DS的长期疗效的潜在差异.

关键词:

深度硬骨切除术 (deep sclerectomy) 是一种切除术.玻璃眼 glaucoma 玻璃眼玻璃眼玻璃眼玻璃眼玻璃眼外科手术的结果主要的开放角光眼 (Glaucoma)伪剥皮青光眼青光眼青光眼视网膜神经纤维层是一种神经纤维层.

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