Park Masami, Hayashi Ken, Takahashi Hirokazu, Shoji Takuhei, Chihara Etsuo
Sensho-kai Eye Institute daggerthe Department of Ophthalmology, Takeda Hospital in Kyoto, Japan.
J Glaucoma. 2008 Sep;17(6):431-5. doi: 10.1097/IJG.0b013e31815f52df.
To determine factors affecting the outcome of phacoviscocanalostomy in patients with cataract and primary open-angle glaucoma.
Factors for controlling intraocular pressure (IOP) were investigated in 180 patients using Cox multivariate proportional hazards survival regression.
The mean preoperative IOP of 20.2+/-3.8 mm Hg decreased significantly (P<0.0001) to 15.3+/-2.6 mm Hg for 5 years postoperatively. The success probabilities defined as an IOP of 17 mm Hg or less or a 20% or greater reduction were 47.2% with or without medications and 31.4% without medications at 5 years. Preoperative IOP level [P=0.0013; odds ratio (OR), 1.14] and age (P=0.037; OR, 0.97) were risk factors in the success probability with or without medications. In the analysis without medications, the preoperative IOP (P<0.001; OR, 1.12), the preoperative number of antiglaucoma medications (P=0.033; OR, 1.27), age (P=0.003; OR, 0.96), and IOP spikes (P=0.028; OR, 1.22) were associated with failure. Sex, peeling of juxtacanalicular tissue, ruptured Descemet membrane, fibrin formation, and hyphema did not affect surgical outcomes.
High preoperative IOP, the number of preoperative medications, postoperative IOP spikes (>30 mm Hg) increased the risk of failed IOP control after phacoviscocanalostomy. Increasing patient age decreased the risk of failure.
确定影响白内障合并原发性开角型青光眼患者超声乳化小梁切开术预后的因素。
采用Cox多因素比例风险生存回归分析，对180例患者控制眼压（IOP）的因素进行研究。
术前平均眼压为20.2±3.8 mmHg，术后5年显著降低（P<0.0001）至15.3±2.6 mmHg。以眼压≤17 mmHg或降低20%及以上定义的成功率，在使用或不使用药物的情况下，5年时为47.2%，不使用药物时为31.4%。术前眼压水平[P=0.0013；优势比（OR），1.14]和年龄（P=0.037；OR，0.97）是使用或不使用药物情况下成功率的危险因素。在不使用药物的分析中，术前眼压（P<0.001；OR，1.12）、术前抗青光眼药物数量（P=0.033；OR，1.27）、年龄（P=0.003；OR，0.96）和眼压峰值（P=0.028；OR，1.22）与手术失败相关。性别、小梁网组织剥除、Descemet膜破裂、纤维蛋白形成和前房积血不影响手术效果。
术前高眼压、术前药物数量、术后眼压峰值（>30 mmHg）增加了超声乳化小梁切开术后眼压控制失败的风险。患者年龄增加可降低失败风险。
