Trabeculotomy

小梁切开术
  • 文章类型: Journal Article
    目的:评价超声乳化白内障吸出术联合眼管成形术和小梁切开治疗原发性闭角型青光眼(PACG)的疗效。
    方法:在本回顾性研究中,连续的,单外科医生病例系列,我们分析了接受手术的PACG患者的术前和术后测量结果.记录不良事件。主要结果是随访年每个四分位数的平均眼内压(IOP),以及每个四分位数结束时患者服用的降低IOP药物的数量与基线值相比。
    结果:共纳入39例PACG患者的46只眼。术前眼压和青光眼药物治疗分别为19.33±6.03mmHg和1.80±1.39(N=46)。术后四个四分位数的IOP平均值(mmHg)为14.00±3.33(N=44),13.44±2.83(N=32),14.38±2.39(N=16),和14.92±2.90(N=13)(p<0.0001)。每个四分位数的平均用药数为0.32±0.80、0.22±0.42、0.59±0.80和0.08±0.28(p<0.0001),而所有四分位数的中位数为0。
    结论:与基线测量相比,将OMNI手术系统与超声乳化术联合使用可显著降低平均IOP和降低IOP的药物数量。
    OBJECTIVE: To evaluate the outcomes of combined canaloplasty and trabeculotomy with phacoemulsification for primary angle-closure glaucoma (PACG).
    METHODS: In this retrospective, consecutive, single-surgeon case series, we analyzed the pre- and postoperative measurements of PACG patients who had the procedure. Adverse events were recorded. The main outcomes were mean intraocular pressure (IOP) in each quartile of the follow-up year and the number of IOP-lowering medications the patients were on by the end of each quartile compared to their baseline values.
    RESULTS:  A total of 46 eyes from 39 PACG patients were included. The preoperative IOP and glaucoma medications taken were 19.33±6.03 mm Hg and 1.80±1.39, respectively (N=46). Postoperative IOP means (mm Hg) in the subsequent four quartiles were 14.00±3.33 (N=44), 13.44±2.83 (N=32), 14.38±2.39 (N=16), and 14.92±2.90 (N=13) (p<0.0001). The mean number of meds was 0.32±0.80, 0.22±0.42, 0.59±0.80, and 0.08±0.28 in each respective quartile (p<0.0001), while the median was 0 across all quartiles.
    CONCLUSIONS: Combining the OMNI surgical system with phacoemulsification led to substantial reductions in mean IOP and the number of IOP-lowering medications when compared to baseline measurements.
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  • 文章类型: Case Reports
    背景:Fuchs葡萄膜炎综合征(FUS)是一种慢性眼内炎症性疾病。它可能导致青光眼,这对医学和手术治疗都是棘手的。在本报告中,我们描述了将GATT作为治疗FUS继发青光眼的主要手术选择的经验.
    结果:4例FUS相关性青光眼患者在一个机构接受了GATT。病例1是一名28岁的假晶状体男性,术前眼压(IOP)为43mmHg,但未成功进行圆周插管;GATT后,他的IOP仍然很高,并接受了小梁切除术,然后进行了Ahmed青光眼阀(AGV)植入术以控制IOP。虽然AGV后IOP稳定,由于持续的角膜去膨胀,他需要进行角膜膜内皮移植术。他在21个月内有12mmHg的稳定IOP。病例2是一名42岁的男性,术前眼压为35mmHg,后囊下白内障进行了360度GATT联合超声乳化术;他的眼压在18个月内降至14mmHg。病例3是一名52岁的假晶状体男性,术前IOP为28mmHg,患有360度GATT;他的IOP在18个月内保持稳定在10mmHg。病例4是一名47岁的假晶状体女性,术前IOP为39mmHg,患有360度GATT;她的IOP在12个月内保持稳定在14mmHg。
    结论:GATT可作为FUS继发性青光眼的初始治疗方法。但是,仍需要进一步的证据来更好地确定GATT在这一特定患者人群中的有效性.
    BACKGROUND: Fuchs uveitis syndrome (FUS) is a chronic intraocular inflammatory disease. It can lead to glaucoma which can be intractable to both medical and surgical treatment. In the present report, we describe our experience with GATT as a primary surgical option in the treatment of glaucoma secondary to FUS.
    RESULTS: Four consecutive patients with FUS-associated glaucoma underwent GATT in a single institution. Case 1 was a 28-year-old pseudophakic male with a preoperative intraocular pressure (IOP) of 43 mmHg had unsuccessful circumferential cannulation; his IOP remained high after GATT and received trabeculectomy followed by Ahmed glaucoma valve (AGV) implantation to control IOP. Although IOP was stable following AGV, he required descemet membrane endothelial keratoplasty due to persistent corneal decompansation. He had a stable IOP of 12 mmHg over 21 months. Case 2 was a 42-year-old male with preoperative IOP of 35 mmHg and posterior subcapsular cataract had 360-degree GATT combined with phacoemulsification; his IOP reduced to 14 mmHg over 18 months. Case 3 was an 52-year-old pseudophakic male with a preoperative IOP of 28 mmHg had 360-degree GATT; his IOP remained stable at 10 mmHg over 18 months. Case 4 was an 47-year-old pseudophakic female with a preoperative IOP of 39 mmHg had 360-degree GATT; her IOP remained stable at 14 mmHg over 12 months.
    CONCLUSIONS: GATT may be used as an initial approach in secondary glaucoma due to FUS. But, further evidence is still warranted to better ascertain the usefulness of GATT in this specific patient population.
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  • 文章类型: Case Reports
    UNASSIGNED: To describe our experience of Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in four eyes with infantile primary congenital glaucoma (PCG).
    UNASSIGNED: We report the first two GATT procedures performed in six-month-old infants with PCG. We also report the same procedure in two eyes of a two-year-old boy with PCG who had previous goniotomies with subsequent peripheral anterior synechiae formation. In all four eyes, the IOP remained under 20 mmHg at years three and four postoperatively, without glaucoma medication or conjunctival surgery.
    UNASSIGNED: Our cases confirm that GATT is an alternative to traditional ab externo glaucoma surgery in PCG and can be successfully performed within the first months of life, or in infants with failed or partially functioning goniotomies, avoiding the need for invasive conjunctival or scleral surgery.
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