Ophthalmic Consultants of Boston, Center for Eye Research and Education, Boston, Massachusetts, USA.
J Cataract Refract Surg. 2011 Nov;37(11):1961-70. doi: 10.1016/j.jcrs.2011.05.036. Epub 2011 Sep 9.
To assess the short- and long-term effect of uneventful phacoemulsification, posterior chamber intraocular lens (IOL) implantation, and trabeculectomy on intraocular pressure (IOP) and glaucoma medication requirements in eyes with pseudoexfoliation glaucoma (PXG) and compare the results with those in eyes that had uneventful phacoemulsification only (reported in a previous study of the same cohort of pseudoexfoliation eyes).
Private practice, Boston, Massachusetts, USA.
Comparative case series.
A retrospective analysis was performed of consecutive PXG eyes that had uneventful combined phacoemulsification and trabeculectomy by the same surgeon. The change in IOP, glaucoma medication requirements, and logMAR corrected distance visual acuity was compared between the combined surgery group and the phaco-alone group.
The combined-surgery group (n = 138) had statistically significant reduced mean IOP and glaucoma medication requirements through 10 years postoperatively (P<.018). The change in IOP and glaucoma medication requirements was greater in the combined-surgery group than in the phaco-alone group (n = 240); this was statistically significant up to 7 years postoperatively (P<.022). The reduction in mean postoperative IOP was greater in eyes with a higher mean preoperative IOP. In the combined-surgery group, 13.8% of eyes required subsequent laser trabeculoplasty, glaucoma surgery, or both.
Uneventful phacoemulsification, IOL implantation, and trabeculectomy resulted in significant long-term reduction in IOP and glaucoma medication requirements in eyes with PXG. Combined procedures resulted in greater and more longstanding reductions in IOP and glaucoma medication requirements and fewer 1-day postoperative IOP spikes than phacoemulsification alone.
No author has a financial or proprietary interest in any material or method mentioned.
评估无并发症的超声乳化白内障吸除术、后房型人工晶状体（IOL）植入术和小梁切除术对假性剥脱性青光眼（PXG）眼的眼压（IOP）和青光眼药物治疗需求的短期和长期影响，并与仅行无并发症超声乳化白内障吸除术（先前对同一批 PXG 眼队列进行的研究报告）的结果进行比较。
美国马萨诸塞州波士顿的私人诊所。
回顾性病例系列研究。
对同一外科医生进行的无并发症联合超声乳化白内障吸除术和小梁切除术的连续 PXG 眼进行回顾性分析。比较联合手术组和单独白内障手术组之间的 IOP 变化、青光眼药物治疗需求和对数矫正视力（logMAR）。
联合手术组（n = 138）在术后 10 年内有统计学意义的平均 IOP 和青光眼药物治疗需求降低（P<.018）。联合手术组的 IOP 和青光眼药物治疗需求的变化大于单独白内障手术组（n = 240）；直到术后 7 年，这种差异才有统计学意义（P<.022）。在平均术前IOP较高的眼中，术后平均IOP 的降低幅度更大。在联合手术组中，13.8%的眼需要随后进行激光小梁成形术、青光眼手术或两者联合。
无并发症的超声乳化白内障吸除术、IOL 植入术和小梁切除术可显著降低 PXG 眼的 IOP 和青光眼药物治疗需求，且长期有效。与单独的超声乳化白内障吸除术相比，联合手术可显著降低眼压，减少青光眼药物的使用，并减少术后第 1 天的眼压升高。
没有作者对任何材料或方法有财务或专有利益。
