背景:这项回顾性研究旨在评估房角镜辅助经腔小梁切开术(GATT)在中国原发性先天性青光眼(PCG)患者中的疗效和安全性,并确定影响手术成功的因素。
方法:招募了14例诊断为PCG的患者(24只眼),这些患者接受了房角镜辅助的经腔小梁切开术,和眼内压(IOP)的数据,抗青光眼药物,手术相关并发症,在术前和术后访视期间收集其他治疗方法。手术成功率定义为IOP≤21mmHg且比基线降低>30%。有(部分成功)或没有(完全成功)抗青光眼药物。
结果:术前平均IOP为30.41±6.09mmHg。在最后一次访问中,平均眼压下降16.1±9.1mmHg(52%),24只眼中有19只眼不使用局部药物。与基线相比,每次术后随访的IOP均显着降低(所有时间点P<0.05)。完全和部分成功的累积比例分别为79.2%和95.8%,分别,手术后三年.之前没有抗青光眼手术的患者,没有术后IOP峰值,接受完全小梁切开术的患者手术预后改善.到各自的随访结束时,24只眼均未发生永久性视力威胁并发症。
结论:房角镜辅助经腔小梁切开术是一种安全有效的PCG治疗方法,具有显著的眼压降低效果和较高的手术成功率。
BACKGROUND: This retrospective study aimed to evaluate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in Chinese patients with primary congenital glaucoma (PCG) and identify factors influencing surgical success.
METHODS: Fourteen patients (24 eyes) diagnosed with PCG who underwent gonioscopy-assisted transluminal trabeculotomy were recruited, and data on intraocular pressure (IOP), antiglaucoma medication, surgery-related complications, and additional treatments were collected during preoperative and postoperative visits. Surgical success was defined as IOP ≤ 21 mmHg and a reduction of > 30% from baseline, with (partial success) or without (complete success) antiglaucoma medication.
RESULTS: Mean preoperative IOP was 30.41 ± 6.09 mmHg. At the final visit, mean IOP reduction was 16.1 ± 9.1 mmHg (52%), and 19 of 24 eyes were topical medication-free. IOP was significantly decreased at each postoperative visit compared with baseline (P < 0.05 for all time points). Cumulative proportions of complete and partial success were 79.2% and 95.8%, respectively, at three years postsurgery. Patients without prior antiglaucoma procedures, without postoperative IOP spikes, and those undergoing complete trabeculotomy exhibited improved surgical prognosis. No permanent vision-threatening complications occurred in the 24 eyes by the end of the respective follow-ups.
CONCLUSIONS: Gonioscopy-assisted transluminal trabeculotomy emerged as a safe and effective procedure for PCG treatment, characterized by outstanding IOP reduction efficacy and high surgical success rates.