镜下辅助腔内小梁切开术治疗斯特奇-韦伯综合征继发早发性青光眼的疗效。

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma Pub Date : 2025-07-01 DOI:10.1016/j.ogla.2025.03.009

Zeynep Aktas MD, FGS , Yasmine El Sayed MD, MRCSEd , Ahmet Yucel Ucgul MD, FRCS , Ghada Gawdat MD , Hala Elhilali MD , Fayrouz Aboalazayem MD

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引用次数: 0

摘要

目的：评价镜下腔内小梁切开术（GATT）治疗斯特奇-韦伯综合征（SWS）继发早发性青光眼的有效性和安全性。设计：回顾性介入病例系列。研究对象：回顾了16例（22只眼）经GATT手术诊断为SWS继发早发性青光眼的患者的医疗记录。方法：所有患者在全麻下行GATT手术，采用5-0或6-0丙烯缝合。主要结局指标：主要结局为眼压（IOP）降低、手术完全成功（IOP≤18mmhg，无药物治疗）、手术合格成功（IOP≤18mmhg，有药物治疗）和术后并发症。结果：平均IOP从基线时的25.4±4.8 mmHg显著下降到最后随访时的15.7±4.2 mmHg (p < 0.001)，下降38.19%。GATT手术时平均年龄为33.6±33.9个月。平均随访时间16.3±6.4个月。手术完全成功率为45.4%(10 / 22)，合格成功率为81.8%（18 / 22）。尽管总体成功，18.1%的眼睛（4只眼睛）在随访期间需要额外的手术干预。其中包括一只眼的Ahmed青光眼瓣膜植入术、两只眼的小梁切除术和一只眼的经巩膜二极管激光循环光凝术。短暂性前房积血是唯一报道的并发症，在一周内自行消退，无需进一步干预。结论：GATT似乎是治疗SWS患者早发性青光眼的一种有希望的手术选择，在我们研究的限制范围内，GATT提供了显著的IOP降低和良好的安全性。然而，需要更长的随访期和比较组的进一步研究来证实这些发现。

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Outcomes of Gonioscopy-Assisted Transluminal Trabeculotomy in Children with Early-Onset Glaucoma Secondary to Sturge–Weber Syndrome

Purpose

To evaluate the effectiveness and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in managing early-onset glaucoma secondary to Sturge–Weber syndrome (SWS).

Design

A retrospective interventional case series.

Participants

Medical records of 16 patients (22 eyes) diagnosed with early-onset glaucoma secondary to SWS who underwent GATT surgery were reviewed.

Methods

All patients underwent GATT surgery using a 5-0 or 6-0 prolene suture under general anesthesia.

Main Outcome Measures

The primary outcomes were intraocular pressure (IOP) reduction, complete surgical success (IOP ≤ 18 mmHg without medications), qualified surgical success (IOP ≤ 18 mmHg with medications), and postoperative complications.

Results

The mean IOP decreased significantly from 25.4 ± 4.8 mmHg at baseline to 15.7 ± 4.2 mmHg at the final follow-up (P < 0.001), representing a 38.19% reduction. The mean age at the time of GATT surgery was 33.6 ± 33.9 months. The mean follow-up duration was 16.3 ± 6.4 months. Complete surgical success was achieved in 45.4% of eyes (10 out of 22), while qualified success was reached in 81.8% of eyes (18 out of 22). Despite the overall success, 18.1% of eyes (4 eyes) required additional surgical interventions during the follow-up period. These included Ahmed glaucoma valve implantation in 1 eye, trabeculectomy in 2 eyes, and transscleral diode laser cyclophotocoagulation in 1 eye. Transient hyphema was the only reported complication, resolving spontaneously within 1 week without further intervention.

Conclusions

Gonioscopy-assisted transluminal trabeculotomy appears to be a promising surgical option for managing early-onset glaucoma in patients with SWS, offering significant IOP reduction and a favorable safety profile within the limitations of our study. However, further studies with longer follow-up periods and comparative groups are necessary to confirm these findings.