Matlach Juliane, Hoffmann Niels, Freiberg Florentina J, Grehn Franz, Klink Thomas
Department of Ophthalmology, University of Wuerzburg, Wuerzburg, Germany.
Clin Ophthalmol. 2012;6:1019-27. doi: 10.2147/OPTH.S32503. Epub 2012 Jul 6.
The purpose of this study was to compare the outcomes of trabeculectomy using single sutures or releasable sutures.
This retrospective study analyzed the medical records of 61 patients who had undergone trabeculectomy using single sutures (n = 33, 54.1%) or releasable sutures (n = 28, 45.9%). The scleral flap was secured with a mean 3.9 (range 3-5) single sutures in 33 patients and with three releasable sutures in 28 patients. Primary outcomes were the success rate, based on intraocular pressure and medication usage, and the frequency of complications and post-surgical interventions. The criteria used to determine complete success were, first, intraocular pressure < 18 mmHg and, second, ≤21 mmHg and ≥20% intraocular pressure reduction without glaucoma medication.
All patients had an intraocular pressure ≤ 21 mmHg; 87.5% in the single suture group and 92.6% in the releasable suture group had an intraocular pressure < 18 mmHg at 24 months. There was a highly significant reduction in intraocular pressure to baseline values in both groups at the last visit. Applying the first criterion, complete success was achieved in 57.6% of patients with single sutures and 71.4% with releasable sutures, and based on the second criterion, 66.7% and 71.4%, respectively. No significant difference was found between the groups with regard to intraocular pressure, or success or complication rates.
The results of trabeculectomy using single sutures or releasable sutures are equivalent. Therefore, the choice of suture technique should be based on individual patient requirements and surgeon experience.
本研究旨在比较使用单根缝线或可松解缝线进行小梁切除术的效果。
这项回顾性研究分析了61例行小梁切除术患者的病历,其中使用单根缝线的患者有33例(54.1%),使用可松解缝线的患者有28例(45.9%)。33例患者用平均3.9根(范围3 - 5根)单根缝线固定巩膜瓣,28例患者用3根可松解缝线固定。主要结局指标为基于眼压和药物使用情况的成功率、并发症发生频率及术后干预情况。判定完全成功的标准为:第一,眼压<18 mmHg;第二,眼压≤21 mmHg且在未使用青光眼药物情况下眼压降低≥20%。
所有患者眼压均≤21 mmHg;单根缝线组87.5%的患者和可松解缝线组92.6%的患者在24个月时眼压<18 mmHg。两组在末次随访时眼压均较基线值有极显著降低。按照第一个标准,单根缝线组57.6%的患者和可松解缝线组71.4%的患者取得了完全成功;按照第二个标准,分别为66.7%和71.4%。两组在眼压、成功率或并发症发生率方面未发现显著差异。
使用单根缝线或可松解缝线进行小梁切除术的效果相当。因此,缝线技术的选择应基于患者个体需求和术者经验。