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目的:探讨深层巩膜切除联合透明质酸片植入(DSHI)治疗原发性开角型青光眼(POAG)的临床疗效。方法:回顾性总结在Saarland大学眼科医院行DSHI治疗的POAG。结果:符合条件并入选的有216患者的377只POAG。平均随诊31(5～51)mo。术前平均眼压(28.3±8.4)mmHg(1mmHg=0.133kPa),术后1wk,6mo,1、2、3、4a眼压分别为(9.7±3.6)、(12.4±5.3)、(15.5±8.7)、(15.4±6.8)、(16.1±6.7)、(17.4±7.5)mmHg。术前平均视力为0.65,术后1wk,6mo,1、2、3、4a视力分别为0.63、0.68、0.72、0.71、0.76、0.70。术后1a显效(不加抗青光眼药物且眼压≤21mmHg)率为89%,有效(加抗青光眼药物时眼压≤21mmHg)率为9%。术后4a时,显效率为45%,有效率48%。并发症包括切口渗漏、前房出血、脉络膜脱离等。结论:DSHI对POAG治疗效果良好,并发症少且轻微。
Objective: To investigate the clinical effect of deep sclerectomy combined with hyaluronic acid (DSHI) in the treatment of primary open-angle glaucoma (POAG). Methods: A retrospective review of the POAG treated with DSHI at the Sahland Eye Hospital was performed. RESULTS: A total of 377 POAGs of 216 patients were eligible and enrolled. The average follow-up of 31 (5 ~ 51) mo. The mean intraocular pressure (IOP) was (28.3 ± 8.4) mmHg (1mmHg = 0.133kPa) before operation and 9.7 ± 3.6, 12.4 ± 5.3 and 15.5 ± 8.7), (15.4 ± 6.8), (16.1 ± 6.7), (17.4 ± 7.5) mmHg. The average preoperative visual acuity was 0.65, 1wk, 6mo, 1,2,3,4a postoperative visual acuity were 0.63,0.68,0.72,0.71,0.76,0.70. Postoperative 1a effective (without anti-glaucoma medication and intraocular pressure ≤ 21mmHg) rate was 89%, effective (plus anti-glaucoma medication intraocular pressure ≤ 21mmHg) rate of 9%. After 4a, markedly effective rate was 45%, the effective rate of 48%. Complications include incisional leakage, anterior chamber hemorrhage, and choroidal detachment. Conclusion: DSHI has good effect on POAG with few and minor complications.