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超声乳化白内障吸除术联合小梁切除术治疗原发性闭角型青光眼和开角型青光眼。

Phacotrabeculectomy without mitomycin C in primary angle-closure and open-angle glaucoma.

机构信息

VST Glaucoma Center, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Andhra Pradesh, India.

出版信息

J Glaucoma. 2011 Jan;20(1):57-62. doi: 10.1097/IJG.0b013e3181ca7f65.

DOI:10.1097/IJG.0b013e3181ca7f65
PMID:20051881
Abstract

PURPOSE

To compare the surgical outcomes of single site phacotrabeculectomy without mitomycin C (MMC) in primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG).

METHODS

We retrospectively reviewed the records of all patients with a diagnosis of PACG and POAG, who underwent single site phacotrabeculectomy without MMC between January 2001 and December 2005 and had a minimum follow-up of 12 months. The primary outcome measure was cumulative success probability, defined as complete [intraocular pressure (IOP) ≤21 mm Hg without antiglaucoma medications or additional surgery] and qualified (IOP <21 mm Hg with medications). Secondary outcome measures were reduction of IOP, the number of antiglaucoma medications at last follow-up, and complication rates.

RESULTS

Seventy-one eyes of 63 PACG patients (mean age 61.2 y) and 72 eyes of 57 POAG patients (mean age 64.0 y) were analyzed. Mean duration of follow-up was 38.7 and 41.7 months in the PACG and POAG groups, respectively. Complete success in PACG (72.1%) was more than the POAG group (56.1%), but the difference was not statistically significant (P=0.06). Qualified success in the PACG and POAG group was 87.4% and 92.8%, respectively (P=0.43). IOP reduction was greater (P=0.03) in the PACG group and PACG group required fewer antiglaucoma medications postoperatively (P=0.03) for IOP control.

CONCLUSIONS

Survival probability of single site phacotrabeculectomy without MMC was not significantly different between the PACG and POAG groups. IOP reduction was greater and the need for antiglaucoma medications after surgery was lesser in the PACG group.

摘要

目的

比较原发性闭角型青光眼(PACG)和原发性开角型青光眼(POAG)患者行单一部位无丝裂霉素 C(MMC)的超声乳化白内障吸除联合小梁切除术的手术效果。

方法

我们回顾性分析了 2001 年 1 月至 2005 年 12 月期间行单一部位无 MMC 的超声乳化白内障吸除联合小梁切除术的 PACG 和 POAG 患者的病历资料,随访时间至少 12 个月。主要观察指标为累积成功率,定义为完全成功(眼压(IOP)≤21mmHg 且无需抗青光眼药物或进一步手术)和合格成功(IOP<21mmHg 且需药物治疗)。次要观察指标包括眼压降低、末次随访时的抗青光眼药物数量和并发症发生率。

结果

71 只眼的 63 例 PACG 患者(平均年龄 61.2 岁)和 72 只眼的 57 例 POAG 患者(平均年龄 64.0 岁)纳入分析。PACG 组和 POAG 组的平均随访时间分别为 38.7 个月和 41.7 个月。PACG 组的完全成功率(72.1%)高于 POAG 组(56.1%),但差异无统计学意义(P=0.06)。PACG 组和 POAG 组的合格成功率分别为 87.4%和 92.8%(P=0.43)。PACG 组的眼压降低更显著(P=0.03),PACG 组术后需要的抗青光眼药物更少(P=0.03)以控制眼压。

结论

在单一部位无 MMC 的超声乳化白内障吸除联合小梁切除术的生存概率方面,PACG 组和 POAG 组之间无显著差异。PACG 组的眼压降低更显著,术后需要的抗青光眼药物更少。

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