Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
Invest Ophthalmol Vis Sci. 2012 Jul 3;53(8):4485-9. doi: 10.1167/iovs.12-9862.
To evaluate the glaucoma progression in patients with a history of refractive corneal surgery (RCS).
A total of 313 eyes of 313 glaucoma patients (RCS group, 34 eyes; non-RCS group, 279 eyes) with a mean follow-up period of 2.7 years were included. Glaucoma progression was determined either by experts' stereoscopic optic disc/retinal nerve fiber layer (RNFL) photographs or by serial visual field (VF) data. Uni- and multivariate Cox's proportional hazards models were used to determine associations between potential risk factors including a history of RCS and glaucoma progression.
Among 313 eyes, 87 (27.8%) eyes showed progression either by optic disc/RNFL photographs or VF assessment during the follow-up period. Ten (29.4%) of eyes in the RCS group and 77 (27.6%) of eyes in the non-RCS group showed glaucoma progression; however, prevalence of progression did not differ between the two groups (P = 0.482). Among all participants, baseline age and VF pattern standard deviation (PSD; hazard ratios of 1.013 and 1.119; P = 0.026 and P < 0.001, respectively) were significant risk factors for progression. In both the RCS and the non-RCS group, only VF PSD was a significant risk factor for progression according to multivariate Cox proportional hazards (1.193, 1.099, P < 0.001, P < 0.001, respectively).
Baseline VF PSD and age substantially affected glaucoma progression in all study participants, although their RCS history was not a significant risk factor for glaucoma progression.
评估有屈光性角膜手术(RCS)史的患者的青光眼进展情况。
共纳入 313 例青光眼患者的 313 只眼(RCS 组 34 只眼;非 RCS 组 279 只眼),平均随访时间为 2.7 年。通过专家立体视盘/视网膜神经纤维层(RNFL)照片或连续视野(VF)数据来确定青光眼进展情况。采用单变量和多变量 Cox 比例风险模型来确定包括 RCS 史在内的潜在危险因素与青光眼进展之间的关系。
在 313 只眼中,有 87 只(27.8%)眼在随访期间通过视盘/RNFL 照片或 VF 评估显示进展。RCS 组中有 10 只(29.4%)眼和非 RCS 组中有 77 只(27.6%)眼发生青光眼进展;然而,两组的进展发生率无差异(P=0.482)。在所有参与者中,基线年龄和 VF 模式标准差(HR 分别为 1.013 和 1.119;P=0.026 和 P<0.001)是进展的显著危险因素。在 RCS 组和非 RCS 组中,只有 VF PSD 是多变量 Cox 比例风险的显著进展危险因素(1.193、1.099,P<0.001、P<0.001)。
尽管基线 VF PSD 和年龄对所有研究参与者的青光眼进展有显著影响,但他们的 RCS 史并不是青光眼进展的显著危险因素。