PDF(Pubmed)
Abstract：
BACKGROUND: Primary congenital glaucoma causes vision loss if intraocular pressure is uncontrolled. Nonpenetrating deep sclerectomy is effective in treating primary congenital glaucoma. However, the effects of inadvertent trabeculodescemetic window perforation remain unclear.
METHODS: This retrospective cohort study included patients with primary congenital glaucoma who underwent nonpenetrating deep sclerectomy between 2014 and 2021. The perforation group had intraoperative trabeculodescemetic window perforations; the non-perforation group did not. The primary outcome was intraocular pressure between the groups over 15 months. The secondary outcomes included surgical success and complications.
RESULTS: The study included 74 eyes of 44 patients. The cohort comprised 31 perforated and 43 non-perforated eyes. Both groups showed significant intraocular pressure reduction without significant between-group differences in complete (68 vs. 77%), qualified (19 vs. 9%), or failed (13 vs. 14%) treatments. The median intraocular pressure decreased from 39 to 14 mmHg in the perforation group and 35 to 12 mmHg in the non-perforation group. Of the 74 treated eyes, 68 (92%) showed no complications.
CONCLUSIONS: An inadvertent trabeculodescemetic window perforation during nonpenetrating deep sclerectomy for primary congenital glaucoma did not significantly affect intraocular pressure outcomes compared to non-perforated cases over 15 months. Nonpenetrating deep sclerectomy reduced intraocular pressure regardless of intraoperative perforation in patients with primary congenital glaucoma. Perforation of the trabeculodescemetic window was associated with a low incidence of postoperative complications.
METHODS: This retrospective cohort study included patients with primary congenital glaucoma who underwent nonpenetrating deep sclerectomy between 2014 and 2021. The perforation group had intraoperative trabeculodescemetic window perforations; the non-perforation group did not. The primary outcome was intraocular pressure between the groups over 15 months. The secondary outcomes included surgical success and complications.
RESULTS: The study included 74 eyes of 44 patients. The cohort comprised 31 perforated and 43 non-perforated eyes. Both groups showed significant intraocular pressure reduction without significant between-group differences in complete (68 vs. 77%), qualified (19 vs. 9%), or failed (13 vs. 14%) treatments. The median intraocular pressure decreased from 39 to 14 mmHg in the perforation group and 35 to 12 mmHg in the non-perforation group. Of the 74 treated eyes, 68 (92%) showed no complications.
CONCLUSIONS: An inadvertent trabeculodescemetic window perforation during nonpenetrating deep sclerectomy for primary congenital glaucoma did not significantly affect intraocular pressure outcomes compared to non-perforated cases over 15 months. Nonpenetrating deep sclerectomy reduced intraocular pressure regardless of intraoperative perforation in patients with primary congenital glaucoma. Perforation of the trabeculodescemetic window was associated with a low incidence of postoperative complications.
摘要：
背景：如果眼压不受控制，原发性先天性青光眼会导致视力丧失。非穿透性深层巩膜切除术可有效治疗原发性先天性青光眼。然而,目前尚不清楚无意的小梁窗穿孔的影响.
方法：这项回顾性队列研究包括2014年至2021年接受非穿透性深层巩膜切除术的原发性先天性青光眼患者。穿孔组在术中出现小梁开窗穿孔；非穿孔组则没有。主要结果是两组间超过15个月的眼内压。次要结果包括手术成功和并发症。
结果：该研究包括44名患者的74只眼。该队列包括31只穿孔的眼睛和43只非穿孔的眼睛。两组均显示显著的眼内压降低，组间完全无显著差异（68vs.77%），合格（19与9%)，或失败(13vs.14%）处理。穿孔组的中位眼压从39降至14mmHg，非穿孔组的中位眼压从35降至12mmHg。在74只接受治疗的眼睛中，68（92%）显示无并发症。
结论：原发性先天性青光眼非穿透性深层巩膜切除术期间无意中出现的小梁状开窗穿孔，与超过15个月的未穿孔病例相比，并未显著影响眼压结果。非穿透性深层巩膜切除术可降低原发性先天性青光眼患者的眼压，而与术中穿孔无关。小梁窗的穿孔与术后并发症的低发生率相关。
方法：这项回顾性队列研究包括2014年至2021年接受非穿透性深层巩膜切除术的原发性先天性青光眼患者。穿孔组在术中出现小梁开窗穿孔；非穿孔组则没有。主要结果是两组间超过15个月的眼内压。次要结果包括手术成功和并发症。
结果：该研究包括44名患者的74只眼。该队列包括31只穿孔的眼睛和43只非穿孔的眼睛。两组均显示显著的眼内压降低，组间完全无显著差异（68vs.77%），合格（19与9%)，或失败(13vs.14%）处理。穿孔组的中位眼压从39降至14mmHg，非穿孔组的中位眼压从35降至12mmHg。在74只接受治疗的眼睛中，68（92%）显示无并发症。
结论：原发性先天性青光眼非穿透性深层巩膜切除术期间无意中出现的小梁状开窗穿孔，与超过15个月的未穿孔病例相比，并未显著影响眼压结果。非穿透性深层巩膜切除术可降低原发性先天性青光眼患者的眼压，而与术中穿孔无关。小梁窗的穿孔与术后并发症的低发生率相关。
