Roth S M, Spaeth G L, Starita R J, Birbillis E M, Steinmann W C
William and Anne Goldberg Glaucoma Service, Wills Eye Hospital, Thomas Jefferson Medical College, Philadelphia, PA 19107.
Ophthalmic Surg. 1991 Dec;22(12):724-9.
A randomized, prospective study on 68 eyes of 54 patients with progressive, uncontrolled, noninflammatory open-angle glaucoma showed that eyes that received topical prednisolone 1% had a lower intraocular pressure (IOP) 18 months following trabeculectomy than the eyes that received no prednisolone. The addition of systemic prednisone had no definite further effect. In the present study, we reevealuated 58 eyes of 45 of these patients 5 years after the time of initial surgery. The number of cases lost to follow up was similar in the steroid and the nonsteroid-treated groups. Mean IOP of the steroid-treated patients was 14.5 +/- 1.8 mm Hg, and of the nonsteroid-treated patients, 19.3 +/- 2.1 mm Hg. Visual field, optic disc, and IOP were stabilized in 94% of the steroid-treated cases and in 43% of the nonsteroid-treated cases. Thus, postoperative steroids significantly increased the success rate of trabeculectomy in these eyes, and the eyes with lower IOPs had a significantly better prognosis than those with higher IOPs.
一项针对54例进行性、未控制的非炎性开角型青光眼患者的68只眼睛的随机前瞻性研究表明，接受1%局部泼尼松龙治疗的眼睛在小梁切除术后18个月时的眼压低于未接受泼尼松龙治疗的眼睛。加用全身性泼尼松龙没有明确的进一步效果。在本研究中，我们在初次手术后5年对其中45例患者的58只眼睛进行了重新评估。类固醇治疗组和非类固醇治疗组失访的病例数相似。类固醇治疗患者的平均眼压为14.5±1.8 mmHg，非类固醇治疗患者为19.3±2.1 mmHg。94%的类固醇治疗病例和43%的非类固醇治疗病例的视野、视盘和眼压得到稳定。因此，术后使用类固醇显著提高了这些眼睛小梁切除术的成功率，眼压较低的眼睛预后明显优于眼压较高的眼睛。
