Ex-PRESSTM併用濾過手術の術後短期成績

Short-term outcome of surgery with Ex-PRESSTM for glaucoma

要約　目的：開放隅角緑内障に対するEx-PRESS^TM併用濾過手術の術後短期成績の報告。対象と方法：Ex-PRESS^TM併用濾過手術が施行された20例20眼。男性16例，女性4例。平均年齢は64.4±13.1歳。術後3か月間の眼圧，合併症および線維柱帯切除術の結果との比較を行った。結果：Ex-PRESS^TM併用濾過手術施行前の術前平均眼圧は35.2±7.2mmHgで，1か月後は15.3±4.9mmHg，3か月後は16.1±4.7mmHgと有意に下降していた（p＜0.001）。線維柱帯切除術群では術前眼圧は平均32.5±8.4mmHg，術後1か月後は13.4±4.7mmHg，3か月後で14.0±5.7mmHgと両群ともほぼ同様の眼圧下降効果であった。Ex-PRESS^TM併用濾過手術の合併症は前房出血，本体偏位，低眼圧，高眼圧などで，線維柱帯切除術群と有意差はなかった。結論：Ex-PRESS^TM併用濾過手術は安全な手術手技であり，眼圧下降効果および合併症の頻度は線維柱帯切除術と短期的にはほぼ同様であった。

Abstract.　Purpose：To report the outcome of surgery with Ex-PRESS^TM for glaucoma. Cases and Method：This retrospective study was made on 20 eyes of 20 patients who received implantation of Ex-PRESS^TM for glaucoma. The series comprised 16 males and 4 females. The age averaged 64.4±13.1 years. There were 15 eyes with primary open-angle glaucoma and 5 eyes with neovascular glaucoma. Eight eyes were phakic, 8 were pseudophakic, and 4 were aphakic. They were followed up for 3 months or longer. The outcome was compared with that in another series of 20 eyes that received trabeculectomy for glaucoma. Results：Intraocular pressure（IOP）averaged 35.2±7.2 mmHg before surgery. It averaged 15.3±4.9 mmHg one month and 16.1±4.7 mmHg 3 months after surgery. There was no significant difference in the course of IOP between the current series and those treated by trabeculectomy. No difference was present between the two groups regarding complications including hyphema, ocular hypotony, or raised IOP. Conclusion：Implantation of Ex-PRESS^TM was a safe and effective procedure for glaucoma. Complications and ocular hypotensive effect were similar to those after trabeculectomy.