EX-PRESS引流钉植入术对POAG患者角膜内皮细胞及眼压的影响

Effect of EX-PRESS miniature glaucoma device implantation on corneal endothelial cell density and intraocular pressure for primary open angle glaucoma

摘要:

目的：评价EX-PRESS引流钉植入术对原发性开角型青光眼(POAG)患者角膜内皮细胞及眼压的影响。

方法：前瞻性临床研究。收集2016-05/2017-12在我院行EX-PRESS引流钉植入术的原发性开角型青光眼患者32例38眼，随访至术后24mo，观察中央、鼻侧、颞侧、上方、下方5个方位的角膜内皮细胞密度、眼压及最佳矫正视力情况，并观察前房深度及引流钉与虹膜、角膜的位置情况及手术疗效。

结果：手术前后，本组患者5个方位的角膜内皮细胞密度和最佳矫正视力均无明显变化(P>0.05)，但术后各时间点眼压均较术前明显降低(P<0.05)。术后24mo，本组患者手术完全成功率为66%，条件成功率为21%，失败率为13%，手术失败的主要原因为滤过泡包裹。本组患者术中和术后随访期间均未出现前房完全消失； 术后1眼出现浅前房，5眼引流钉与虹膜面相贴，余32眼引流钉均位于虹膜与角膜内皮之间，位置良好。

结论：EX-PRESS引流钉植入术对POAG患者角膜内皮细胞无明显影响，且能有效控制眼压，是治疗原发性开角型青光眼的安全有效的方法。

Abstract:

AIM:To study the effect of EX-PRESS miniature glaucoma device implantation on corneal endothelial cell density and intraocular pressure for primary open angle glaucoma(POAG).

METHODS:This was a prospective clinical study of 38 eyes in 32 POAG patients who underwent EX-PRESS miniature glaucoma device implantation in our hospital from May 2016 to December 2017. The central, nasal, temporal,superior, inferior endothelium cell density, intraocular pressure(IOP), best corrected visual acuity(BCVA)were observed at 24mo after operation. Anterior chamber depth and the position of drainage nail with iris and cornea were also observed.

RESULTS: There was no significant difference of the corneal endothelium density in five sites and BCVA between preoperation and postoperation(P>0.05). There was significant difference in IOP between pre-operation and postoperation(P<0.05). The complete success rate was 66% and conditional success rate was 21%, the failure rate was 13%. The main cause of failure was filtering bleb scarring. There was no complete disappearance of anterior chamber during the operation and follow-up period. There were 1 eye of shallow anterior chamber, 5 eyes of EX-PRESS contact with iris surface. The position of drainage nail with iris and cornea endothelium was good in the other 32 eyes.

CONCLUSION: The EX-PRESS miniature glaucoma device implantation has no effect on corneal endothelial cells in five directions and can effectively control intraocular pressure. It is a safe and effective method for primary open-angle glaucoma.