| Objective Glaucoma is a common form of irreversible blinding eye disease, quick, harmfulness, visual function damage can lead to blindness. Performance for vision loss, often accompanied by eye bilges, nausea, vomiting, headache, greatly influence the patient’s quality of life. Glaucoma in cash, therefore, has become a serious social problem, choose a more safe and reliable and effective treatment is very important. There are many ways to treatment of glaucoma is roughly divided into surgical treatment, drug therapy, laser therapy. With the development of modern microscopy of ophthalmology, glaucoma filtration surgery success rate reached 70% ~ 90%. But some special type of glaucoma, such as, no crystal eyes glaucoma and neovascular glaucoma traumatic glaucoma, congenital glaucoma, artificial crystal glaucoma, developmental glaucoma, as well as the line filter changed hands many times after glaucoma, etc. Because eye disease complex, difficult to establish an effective filtration channels and cause the failure of surgery, these glaucoma are called refractory glaucoma. Routine trabeculectomy often result in a filter channel scarring, intraocular pressure cause the failure of surgery, elevated intraocular pressure is not reversible damage of visual function. So, how to control the intraocular pressurebecome a problem to be solved. In recent years, some research and development of glaucoma drainage implant applications, such as the Ex- PRESS glaucoma drainage device for the treatment of glaucoma in minimally invasive, safe and convenient in the direction of the development of micro drainage device implanted in glaucoma surgery for glaucoma is indispensable to occupy a place, but there are still a lot of problems. Such as how to choose the surgery, eye conditions determine whether joint surgery, postoperative long-term tracking observation, timely deal with HP and drainage plate weeks fiber wrap, is an effective measure to improve the success rate of surgery. The purpose of this study is to observe the iop after glaucoma trabeculectomy(after surgery failure) Ex- PRESS drainage and the clinical efficacy of drug treatment, and compare the therapeutic effect of two ways.Methods This study is a prospective study. Select our hospital(the first affiliated hospital of zhengzhou university eye first three glaucoma treatment group) in patients with glaucoma(after trabeculectomy 1 time, poor iop control) 55 cases(60 eyes), balancing their clinical parameters, the selected patients without other ocular and systemic anomalies. According to completely random divided into Ex- PRESS group 30 cases(32 eyes), drug treatment group(25 cases(28 eyes), the former of the Ex-PRESS drainage device implantation, the latter taking drug control(thiamethoxam bisoprolol+pie made+su Ming temple), 1 week after operation, respectively, in January, June and October time point respectively record the average intraocular pressure in both groups, vision and complications, surgical success rate and patients’ satisfaction, and carry on the comparison between the two groups. All the data with mean + /- standard deviation, said data statistical analysis by SPSS17.0 software to P < 0.05 for the difference was statistically significant.Results 1. The Ex- PRESS group after 1 week, 1 month, and October, 16 month on average, compared with preoperative intraocular pressure difference was statisticallysignificant(P < 0.05). 2. The Ex- PRESS group and drug group in October after the average intraocular pressure 13.82 + /- 2.35 and 2.35 + /- 2.27, there was no statistically significant differences in between the two groups. 3. The Ex- PRESS group and drug group of patients satisfaction the Ex- PRESS group was higher than drug group, but there was no statistically significant difference. 4. Ex- PRESS group and drug group 10 months after treatment, 16 months vision MS and MD difference between two groups have statistical significance.Conclusion 1. The micro Ex- PRESS the drainage device implantation and effects in drug has obvious effects in the action. 2. The micro Ex- PRESS the drainage device implantation and effects in drug control intraocular pressure level of the former is better. 3. The miniature Ex- PRESS the drainage device implantation is a minimally invasive surgery, postoperative complications, less good control intraocular pressure, and effects in drug compliance of patients had a higher with higher degree requirements. 4. Short term reoperation after trabeculectomy failure effect is good, long term medication and surgery more precisely. |
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