原发性闭角型青光眼与原发性开角型青光眼青光眼手术后的术后并发症
Postoperative complications after glaucoma surgery for primary angle-closure glaucoma vs primary open-angle glaucoma.
作者信息
Tan Yar-Li, Tsou Pei-Fang, Tan Gavin S, Perera Shamira A, Ho Ching-Lin, Wong Tina T, Aung Tin
机构信息
Singapore National Eye Centre, Singapore.
出版信息
Arch Ophthalmol. 2011 Aug;129(8):987-92. doi: 10.1001/archophthalmol.2011.71. Epub 2011 Apr 11.
OBJECTIVES
To investigate the incidence of postoperative complications arising in the first year after trabeculectomy and combined phacotrabeculectomy in eyes with primary angle-closure glaucoma (PACG) vs those with primary open-angle glaucoma (POAG).
METHODS
This was a retrospective study of all glaucoma operations done at a Singapore hospital from January 9, 2001, to December 30, 2004. The types of glaucoma surgery included trabeculectomy and phacotrabeculectomy, all with mitomycin C or fluorouracil. The incidences of postoperative complications and reoperations were analyzed. For those who underwent bilateral or repeated operations, only the first operated eye of each subject was included.
RESULTS
A total of 446 subjects with PACG (112 who underwent trabeculectomy and 334 who underwent phacotrabeculectomy) and 816 subjects with POAG (208 who underwent trabeculectomy and 608 who underwent phacotrabeculectomy) were analyzed. Postoperative complications occurred in 65 of 1262 eyes (5.2%) overall, with 27 eyes (8.4%) in the trabeculectomy group (PACG: 8.0%; 95% confidence interval [CI], 4.3%-14.6%; POAG: 8.7%; 95% CI, 5.5%-13.3%; P > .99) and 38 eyes (4.0%) in the phacotrabeculectomy group (PACG: 5.1%; 95% CI, 3.2%-8.0%; POAG: 3.5%; 95% CI, 2.3%-5.2%; P = .31). The rate of complications was significantly higher in the trabeculectomy group than the phacotrabeculectomy group overall (P = .003), but there was no significant difference between the POAG and PACG groups overall (POAG: 4.8%; 95% CI, 3.5%-6.5%; PACG: 5.8%; 95% CI, 4.0%-8.4%; P = .53). The commonest complication found was hypotony with overfiltration (23 cases [1.8%]), followed by bleb leak (11 cases [0.9%]). There was no significant difference in incidence of reoperations between POAG (2.7%; 95% CI, 1.8%-4.1%) and PACG (4.0%; 95% CI, 2.6%-6.3%) (P = .27).
CONCLUSION
The incidences of postoperative complications and reoperations in the first year after glaucoma surgery were similar for PACG and POAG.
目的
研究原发性闭角型青光眼（PACG）和原发性开角型青光眼（POAG）患者小梁切除术及小梁切除联合白内障超声乳化吸出术术后第一年并发症的发生率。
方法
这是一项对2001年1月9日至2004年12月30日在新加坡一家医院进行的所有青光眼手术的回顾性研究。青光眼手术类型包括小梁切除术和小梁切除联合白内障超声乳化吸出术，均使用丝裂霉素C或氟尿嘧啶。分析术后并发症和再次手术的发生率。对于接受双侧手术或重复手术的患者，仅纳入每位患者的第一只手术眼。
结果
共分析了446例PACG患者（112例行小梁切除术，334例行小梁切除联合白内障超声乳化吸出术）和816例POAG患者（208例行小梁切除术，608例行小梁切除联合白内障超声乳化吸出术）。1262只眼中共有65只眼（5.2%）发生术后并发症，小梁切除术组27只眼（8.4%）（PACG：8.0%；95%置信区间[CI]，4.3%-14.6%；POAG：8.7%；95%CI，5.5%-13.3%；P>.99），小梁切除联合白内障超声乳化吸出术组38只眼（4.0%）（PACG：5.1%；95%CI，3.2%-8.0%；POAG：3.5%；95%CI，2.3%-5.2%；P=.31）。总体而言，小梁切除术组并发症发生率显著高于小梁切除联合白内障超声乳化吸出术组（P=.003），但POAG组和PACG组总体无显著差异（POAG：4.8%；95%CI，3.5%-6.5%；PACG：5.8%；95%CI，4.0%-8.4%；P=.53）。最常见的并发症是低眼压伴滤过过度（23例[1.8%]），其次是滤过泡渗漏（11例[0.9%]）。POAG组（2.7%；95%CI，1.8%-4.1%）和PACG组（4.0%；95%CI，2.6%-6.3%）再次手术发生率无显著差异（P=.27）。
结论
PACG和POAG患者青光眼手术后第一年的术后并发症和再次手术发生率相似。
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