Rekas Marek, Siemiatkowska Anna, Stankiewicz Andrzej
Department of Ophthalmology, Military Health Service Institut, Warsaw.
Klin Oczna. 2008;110(7-9):292-6.
To determinate the influence of hypotonia on the effectiveness of phacoemulsification and deep sclerectomy performed simultanously with the SK-gel implant in 15 months follow up.
The retrospective analysis comprised group I (IOP < or =6 mm Hg)--50 eyes and group II (IOP > 6 mm Hg)--75 eyes. Uncontrolled primary open-angle glaucoma and coexisting cataract were the indication. DBCVA, IOP anterior segment and eye fundus were assessed as well as the number of antiglaucoma medications. The patients were examined on the first and the seventh day as well as at 1, 3, 6, 12 and 15 months. IOP < or = 12.15 and 18 mm Hg was accepted as surgical success criterion. T - Student test was used in statistical analysis and variance was analysed. The survival analysis was worked out with Kaplan-Meier method.
After 15 months the decrease of mean IOP was obtained in group I by 35.9% (p < 0.05) and in group II by 33.5% (p < 0.05). There were no statistical differences between the number of the applied antiglaucoma medications in the investigated groups. Finally, a qualified surgical success was obtained for the criterion < or = 18 mmHg in 97.7% of cases in group I and in 87.9% in group II (p= 0.013). For the criterion < or =15 mm Hg--in group I 84.3% and in group II 66.4% (p < 0.001), whereas for the criterion < or = 12 mm Hg respectively in group 141.2% and in group II 39.3% (p = 0.015). DCBVA 15 months after the surgery was 0.84 +/- 0.24 in group I and 0.71 +/- 0.25 in group II. At the end of the follow up no significant differences of DBCVA were found between the investigated groups (p > 0.05).
Hypotonia is an important positive prognostic factor in the first 24 h after surgery in the case of phacoemulsification, performed at the same time with deep sclerectomy.
确定低眼压对白内障超声乳化吸除术联合深层巩膜切除术同时植入SK凝胶并随访15个月疗效的影响。
回顾性分析包括I组（眼压≤6mmHg）50只眼和II组（眼压>6mmHg）75只眼。入选标准为原发性开角型青光眼且伴有白内障且眼压控制不佳。评估最佳矫正视力（BCVA）、眼压、眼前节和眼底情况以及抗青光眼药物的使用数量。在术后第1天和第7天以及1、3、6、12和15个月对患者进行检查。眼压≤12、15和18mmHg被视为手术成功标准。采用t检验进行统计学分析并分析方差。用Kaplan-Meier方法进行生存分析。
15个月后，I组平均眼压下降35.9%（p<0.05），II组下降33.5%（p<0.05）。研究组间抗青光眼药物使用数量无统计学差异。最后，以≤18mmHg为标准，I组97.7%的病例手术成功，II组为87.9%（p=0.013）。以≤15mmHg为标准，I组为84.3%，II组为66.4%（p<0.001）；以≤12mmHg为标准，I组为41.2%，II组为39.3%（p=0.015）。术后15个月I组的最佳矫正视力（BCVA）为0.84±0.24，II组为0.71±0.25。随访结束时，研究组间最佳矫正视力（BCVA）无显著差异（p>0.05）。
在白内障超声乳化吸除术联合深层巩膜切除术的情况下，低眼压是术后24小时内一个重要的积极预后因素。
