ABSTRACT
@#AIM:To compare the effects after two different surgical methods on visual field and retinal nerve fiber layer(RNFL)thickness in patients with glaucoma. <p>METHODS: Clinical data of 69 cases patients(82 eyes )with glaucoma between December 2015 to May 2017 in our hospital for anti-glaucoma surgery were collected. According to operation method, they were divided into EP group(EX-PRESS glaucoma shunt implantation)and XQ group(trabeculectomy). Intraocular pressure, anterior chamber depth(ACD), anterior chamber capacity(ACV), anterior chamber angle width(ACA), optical pupil diameter(PD), visual acuity, visual sensitivity index mean defect(MD), visual correction pattern standard deviation(CPSD), mean sensitivity(MS)and retinal nerve fiber layer thickness(RNFLT)were observed in the preoperative, postoperative 1mo and postoperative 3mo, and the postoperative complications were compared. <p>RESULTS: Hospitalization time of 3.08±0.42d in the EP group was significantly lower than 4.53±1.28d in the XQ group(<i>t</i>=6.124, <i>P</i><0.05). The visual recovery time of 3.26±0.30d in the EP group was significantly lower than 4.96±1.36d in the XQ group(<i>t</i>=6.920, <i>P</i><0.05). The ACA, ACD and ACV after surgery of two groups were significantly higher than those before operation, and the PD after surgery was lower than before operation, and the differences were not statistically significant between two groups after surgery(<i>P</i>>0.05).The postoperative RNFLT, MD and CPSD were all decreased in both groups(<i>P</i><0.05), and postoperative MS increased(<i>P</i><0.05); compared with XQ group, the postoperative CPSD after surgery in EP group was significantly reduced(<i>P</i><0.05).The total incidence of postoperative complications of EP group was 38%, which was significantly lower than 70% in XQ group, the difference was statistically significant(<i>χ</i><sup>2</sup>=8.094, <i>P</i>=0.004). <p>CONCLUSION: Compared with trabeculectomy, EX-PRESS glaucoma shunt implantation is more effective to slow the progress of vision, and it is more conducive to recovery of the patient's vision after surgery with higher security. The improvement of the thickness of the retinal nerve fibers after EX-PRESS glaucoma shunt implantation is consistent with trabeculectomy.
ABSTRACT
AIM:To observe and analyze the change of visual field and retinal nerve fiber layer thickness of primary open-angle glaucoma ( POAG ) after the Ex-press glaucoma shunt implantation. ●METHODS:A total of 14 patients (24 eyes) with POAG were underwent Ex-press glaucoma shunt implantation. Visual acuity, intraocular pressure ( lOP ) , mean defect ( MD) , pattern standard deviation ( PSD ) , retinal nerve fiber layer thickness ( RNFLT ) , and corneal endothelial cell number were collected preoperatively. Visual acuity and lOP were collected in 1wk, 1 and 3mo postoperatively respectively. Also, MD, PSD, RNFLT, and corneal endothelial cell number were collected preoperatively and 3mo postoperatively respectively. Complication, the additional treatment, success rate were analyzed. ●RESULTS:There was no significant difference (P>0. 05) in visual acuity preoperative and postoperative 1wk, 1, 3mo. Visual acuity did not significantly reduce after operation. Compared with preoperative, there was significant decreased (P 0. 05 ) after postoperative 3mo. Corneal endothelial cell number decrease had significant difference (Z=-2. 585, P=0. 01) between preoperative and postoperative 3mo. Success rate: complete success: 79. 2% ( 19 eyes ); partial success:8. 3% (2 eyes);failure:12. 5% (3 eyes). ●CONCLUSION: Ex-press glaucoma shunt implantation could efficiently decrease the lOP in POAG patients. Although it results in reduction of RNFLT in short time. The visual acuity and visual field keep stable after operation. lt is a safe and effective device for treating primary open-angle glaucoma.