严若华??吴振球??潘泽军??刘劲芳

[摘要] 目的 分析和探讨Ex-press青光眼引流器治疗难治性青光眼的治疗效果。 方法 将2013年1月～2016年1月我院应用Ex-press青光眼引流器治疗难治性青光眼12例（16眼）作为研究对象，观察患者术后的视力改善情况、眼压变化情况、并发症情况。 结果 术后1周，手术完全成功率93.75%（15眼）；随访满1年，完全成功率50%（8眼），部分成功率25%（4眼），总成功率75%。12例难治性青光眼患者术后1个月、12个月的视力分别较术前显著提高，12例难治性青光眼患者术前平均眼压（51.3±9.1）mmHg，术后1个月眼压为（12.34±3.22）mm Hg，术后12个月的眼压为（15.11±3.28）mm Hg，分别与术前比较差异有统计学意义（P<0.05）。术后发生前房积血1眼、一过性低眼压2眼、引流钉入口虹膜堵塞1眼、脉络膜脱离1眼。 结论 Ex-press青光眼引流器治疗难治性青光眼可以明显改善患者术的视力，效的控制眼压、并发症少，值得推广和应用。

[关键词] 难治性青光眼；Ex-press青光眼引流器；并发症；眼压

[中图分类号] R779.6 [文献标识码] A [文章编号] 2095-0616（2017）12-211-03

Clinical study on Ex-press glaucoma drainage instrument in treatment of refractory glaucoma in 12 cases

YAN Ruohua WU Zhenqiu PAN Zejun LIU Jinfang

Meizhou Aier Eye Hospital，Meizhou 514700，China

[Abstract] Objective To analyze and explore treatment effect of Ex-press glaucoma drainage instrument in treatment of refractory glaucoma. Methods 12 patients with refractory glaucoma who were treated with Ex-press glaucoma drainage instrument in our hospital from January 2013 January 2016 were selected as research objects.Visual improvement，changes of intraocular pressure and complications after operation of patients were observed. Results In 1 week after operation，complete success rate of the operation was 93.75% （15 eyes）.In one year of follow-up，complete success rate was 50%（8 eyes）.And partial success rate was 25%（4 eyes） and total success rate was 75%.Visual acuity of 1 month and 2 months after operation of 12 patients with refractory glaucoma was respectively improved.Preoperative average intraocular pressure of 12 patients with refractory glaucoma was （51.3±9.1）mmHg.Intraocular pressure of postoperative 1 month and 12 months were respectively （12.34+3.22）mm Hg and （15.11+3.28）mm Hg， which both had significant differences with that before operation （P<0.05）.After operation， there was 1 eye with hyphema，2 eyes with transient hypotony，1 eye with iris blockage at entrance of drainage nail and 1 eye with choroidal detachment. Conclusion Ex-press glaucoma drainage instrument in treatment of refractory glaucoma can significantly improve postoperative visual acuity of patients and effectively control intraocular pressure.In addition，it has fewer complications，which is worthy of promotion and application.

[Key words] Refractory glaucoma；Ex-press glaucoma drainage instrument；Complication； Intraocular pressure

難治性青光眼又称顽固性青光眼（refractoryglaucoma，RG）是眼科的常见病，临床表现除了视力低下，还伴有顽固眼胀、头痛、恶心、呕吐，严重影响患者的生活质量[1]。难治性青光眼目前临床尚无有效的药物治疗，手术是首选的治疗方法。传统的小梁切除术降低眼压效果较差，且并发症较多[2]；睫状体破坏手术手术量不易控制、并发

症多、且易导致发生低眼压及眼球萎缩[3]；随着房水引流物的不断改进，Ex-press青光眼引流器近年来成为治疗难治性青光眼的一种新方法，其手术成功率显著提高，且并发症明显减少，为难治性青光眼的治疗带来了新的希望[4]。本研究对2013年1月～2016年1月我院应用Ex-press青光眼引流器治疗难治性青光眼12例的临床疗效进行观察和分析，现报道如下。

1 资料与方法

1.1 一般资料

将2013年1月～2016年1月我院应用Ex-press青光眼引流器治疗难治性青光眼12例（16眼）作为研究对象，排除合并严重心、肝、肾等重要器官功能不全者及妊娠期或哺乳期妇女、精神类疾病者。……