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Abstract：
OBJECTIVE: To compare the efficacy and safety of viscocanalostomy plus near-360-degree suture trabeculotomy (VST) with viscocanalostomy plus rigid probe trabeculotomy (VT) in treating primary congenital glaucoma (PCG) over a one-year follow-up.
METHODS: This consecutive retrospective study included patients with PCG confirmed within 3 years of age from March 2017 to October 2019. Efficacy was evaluated by comparing the postoperative intraocular pressure (IOP) curve and the success rate at one year after surgery. Safety was assessed by comparing the postoperative complications. The number of anti-glaucoma agents, horizontal corneal diameter (HCD) and cup-to-disc ratio (C/D) of the two surgical methods were also compared.
RESULTS: Data of 90 eyes from 61 patients were analysed. The baseline parameters of the two groups were similar. The IOP at 12 months after surgery in the VST group was 12.7 ± 4.8 mmHg, while that in the VT group was 15.8 ± 6.5 mmHg. The IOP at 6, 9 and 12 months postoperatively in the VST group was significantly lower than in the VT group (p < 0.05). Viscocanalostomy plus near-360-degree suture trabeculotomy (VST) remained a significant favourable factor for complete one-year success (93.6% versus 74.4%, p = 0.005) but not qualified one-year success (97.9% versus 88.4%, p = 0.06). The number of anti-glaucoma agents, HCD and C/D were reduced in both groups. Postoperative complications were not significantly different between the two groups.
CONCLUSIONS: In children with PCG, VST provides a more durable IOP control than VT over the one-year follow-up, with a similar safety profile.
METHODS: This consecutive retrospective study included patients with PCG confirmed within 3 years of age from March 2017 to October 2019. Efficacy was evaluated by comparing the postoperative intraocular pressure (IOP) curve and the success rate at one year after surgery. Safety was assessed by comparing the postoperative complications. The number of anti-glaucoma agents, horizontal corneal diameter (HCD) and cup-to-disc ratio (C/D) of the two surgical methods were also compared.
RESULTS: Data of 90 eyes from 61 patients were analysed. The baseline parameters of the two groups were similar. The IOP at 12 months after surgery in the VST group was 12.7 ± 4.8 mmHg, while that in the VT group was 15.8 ± 6.5 mmHg. The IOP at 6, 9 and 12 months postoperatively in the VST group was significantly lower than in the VT group (p < 0.05). Viscocanalostomy plus near-360-degree suture trabeculotomy (VST) remained a significant favourable factor for complete one-year success (93.6% versus 74.4%, p = 0.005) but not qualified one-year success (97.9% versus 88.4%, p = 0.06). The number of anti-glaucoma agents, HCD and C/D were reduced in both groups. Postoperative complications were not significantly different between the two groups.
CONCLUSIONS: In children with PCG, VST provides a more durable IOP control than VT over the one-year follow-up, with a similar safety profile.
摘要：
目的：在1年的随访时间内，比较粘头吻合术加近360度缝合小梁切开术（VST）与粘头吻合术加刚性探针小梁切开术（VT）治疗原发性先天性青光眼（PCG）的疗效和安全性。
方法：这项连续的回顾性研究纳入了2017年3月至2019年10月3岁内确诊的PCG患者。通过比较术后眼压（IOP）曲线和术后1年的成功率来评估疗效。通过比较术后并发症来评估安全性。抗青光眼药物的数量，还比较了两种手术方法的水平角膜直径（HCD）和杯盘比（C/D）。
结果：分析了61例患者的90只眼数据。两组的基线参数相似。VST组术后12个月眼压为12.7±4.8mmHg,而VT组为15.8±6.5mmHg。VST组术后6、9、12个月眼压明显低于VT组(p<0.05)。粘头切开术加近360度缝合小梁切开术（VST）仍然是一年完全成功的重要有利因素（93.6％对74.4％，p=0.005)，但不合格的一年成功率(97.9%对88.4%，p=0.06)。抗青光眼药物的数量，两组HCD和C/D均降低。两组术后并发症无明显差异。
结论：在患有PCG的儿童中，在一年的随访中,VST比VT提供更持久的IOP控制,具有类似的安全性。
方法：这项连续的回顾性研究纳入了2017年3月至2019年10月3岁内确诊的PCG患者。通过比较术后眼压（IOP）曲线和术后1年的成功率来评估疗效。通过比较术后并发症来评估安全性。抗青光眼药物的数量，还比较了两种手术方法的水平角膜直径（HCD）和杯盘比（C/D）。
结果：分析了61例患者的90只眼数据。两组的基线参数相似。VST组术后12个月眼压为12.7±4.8mmHg,而VT组为15.8±6.5mmHg。VST组术后6、9、12个月眼压明显低于VT组(p<0.05)。粘头切开术加近360度缝合小梁切开术（VST）仍然是一年完全成功的重要有利因素（93.6％对74.4％，p=0.005)，但不合格的一年成功率(97.9%对88.4%，p=0.06)。抗青光眼药物的数量，两组HCD和C/D均降低。两组术后并发症无明显差异。
结论：在患有PCG的儿童中，在一年的随访中,VST比VT提供更持久的IOP控制,具有类似的安全性。
