[Changing patterns of surgical treatment for glaucoma in the Eye Hospital of Wenzhou Medical University during the past ten years].

Objective: To investigate the patterns of surgical treatment for patients with glaucoma in the Eye Hospital of Wenzhou Medical University from 2005 to 2014. Methods: Retrospective case series about 6 781 glaucoma patients (7 751 eyes) who received surgical treatment from January 1, 2005 to December 31, 2014 in the Eye Hospital of Wenzhou Medical University. Among them, 2 869 were males and 3 912 were females, aged (62±14) years. The data of patients' demographic information, diagnosis and surgical procedures [trabeculectomy, aqueous shunts of ExPRESS and Ahmed for extraocular reservoir, cataract extraction with intraocular lens (IOL) implantation, and combined operations for glaucoma and cataract] were collected and the patterns of surgical treatment were evaluated. SPSS 21.0 statistical software was used, mainly for statistical description of the data. Results: The ratio of trabeculectomies increased between 2005 and 2009, from 48.2% (95/197) to 57.7% (488/846), but decreased to 21.1% (220/1 041) in 2014. The ratio of aqueous shunts of ExPRESS and Ahmed increased to 6.1% (63/1 041) and 7.6% (79/1 041) from 2005 to 2014, respectively. The ratio of cataract extraction with IOL implantation increased to 28.4% (294/1 036) in 2012, but decreased to 21.6% (225/1 041) in 2014. The ratio of combined operations for glaucoma and cataract decreased to 6.6% (47/717) from 2005 to 2010, and increased to 36.6% (381/1 041) in 2014. Over the decade, the ratio of cataract extraction with goniosynechialysis increased from 2.4% (15/623) to 17.7% (184/1 041). The rate of iridotectomy decreased to 0.2% (2/1041) in 2014. Conclusions: Trabeculectomy, cataract surgery and combined surgery for glaucoma with cataract were still the mainstream of glaucoma surgery in the Eye Hospital of Wenzhou Medical University from 2005 to 2014. And the ratio of cataract extraction with IOL implantation, aqueous shunts of ExPRESS and Ahmed, and combined operation for glaucoma and cataract rapidly increased, with cataract extraction with goniosynechialysis increasing most rapidly and becoming the mainstream procedure of treatment for glaucoma and cataract. Inversely, the rate of trabeculectomies and iridotectomies decreased dramatically over this period.(Chin J Ophthalmol, 2018, 54: 184-188).目的： 分析2005至2014年10年间温州医科大学附属眼视光医院青光眼住院患者不同抗青光眼手术分布变化趋势。 方法： 回顾性系列病例研究。收集温州医科大学附属眼视光医院2005年1月1日至2014年12月31日住院接受抗青光眼手术治疗的6 781例（7 751只眼）的临床资料，其中男性2 869例，女性3 912例，平均年龄（62±14）岁。根据抗青光眼手术类型（小梁切除术、ExPRESS引流管植入术、Ahmed引流阀植入术、白内障摘除联合人工晶状体植入术、抗青光眼白内障摘除联合手术等）进行分类，记录各类抗青光眼手术分布变化趋势。采用SPSS 21.0统计软件对数据进行整理和分析，主要为统计学描述。 结果： 小梁切除术在所有抗青光眼手术中所占比例（以眼数比表示）在2005至2009年间逐渐增加，由48.2%（95/197）上升至57.7%（488/846），到2014年下降至21.1%（220/1 041）。ExPRESS引流管植入术和Ahmed引流阀植入术比例在2005至2014年分别增长至6.1%（63/1 041）和7.6%（79/1 041）。白内障摘除联合人工晶状体植入术比例在2005至2012年逐渐上升，到2012年达到28.4%（294/1 036），随后开始下降，2014年降至21.6%（225/1 041）。抗青光眼白内障摘除联合手术比例在2005至2010年缓慢下降，到2010年降至6.6%（47/717），随后开始上升，2014年升至36.6%（381/1 041）；其中房角分离联合白内障摘除术自2007年开始应用至2014年手术比例由2.4%（15/623）增长至17.7%（184/1 041）。虹膜周边切除术比例自2005至2014年呈下降趋势，2014年降至0.2%（2/1 041）。 结论： 2005至2014年温州医科大学附属眼视光医院抗青光眼主流手术和术式仍然是小梁切除术、白内障摘除手术以及抗青光眼白内障摘除联合手术。手术数量呈增长趋势的有白内障摘除联合人工晶状体植入术、抗青光眼白内障摘除联合手术、ExPRESS引流管植入术和Ahmed引流阀植入术，其中房角分离联合白内障摘除术增长最快，已经成为抗青光眼白内障摘除联合手术的主要术式；相反小梁切除术的数量则有下降的趋势，而虹膜周边切除术几乎不再使用。（中华眼科杂志，2018，54：184-188）.