Rajavi Zhale, Moezzi-Ghadim Hashem, Kamrava Kiana
Imam Hossein Hospital, Shahid Beheshti University MC, Tehran, Iran.
J Ophthalmic Vis Res. 2009 Apr;4(2):84-9.
To determine the effect of trabeculectomy on cataract formation or progression in patients with chronic glaucoma.
This controlled clinical trial was performed on patients over 50 years of age with glaucoma who were referred to Imam Hossein Hospital, Tehran, Iran, from 2006 to 2007. Trabeculectomy was indicated only in one eye while the fellow eye had wellcontrolled intraocular pressure with medication(s). The fellow eyes served as controls. Lens opacity was evaluated using three criteria: visual acuity (VA), and Lens Opacification Classification System III (LOCS III) photographs and scores.
Overall 82 eyes of 41 patients including 53.7% male and 46.3% female subjects with mean age of 62.5±9.3 (range 50-75) years were evaluated. Cataract progression in operated eyes was statistically significant according to VA (P=0.02), LOCS III photographs (P=0.05) and LOCS III scores (P=0.01). However, compared to fellow control eyes, cataract progression was significant according to VA (P=0.023) and LOCS III scores (P=0.057) but not based on LOCS III photographs. Mean VA reduction was 2 Snellen lines in operated eyes; there were 3 cases of cataract formation or progression without reduced VA.
Cataracts seem to progress following trabeculectomy; therefore it might be advisable to perform a combined procedure in older patients with moderate lens opacities.
确定小梁切除术对慢性青光眼患者白内障形成或进展的影响。
这项对照临床试验于2006年至2007年在伊朗德黑兰伊玛目侯赛因医院就诊的50岁以上青光眼患者中进行。仅一只眼睛进行小梁切除术，而对侧眼通过药物治疗眼压控制良好。对侧眼作为对照。使用三个标准评估晶状体混浊情况：视力（VA）、晶状体混浊分类系统III（LOCS III）照片和评分。
共评估了41例患者的82只眼睛，其中男性占53.7%，女性占46.3%，平均年龄为62.5±9.3岁（范围50 - 75岁）。根据视力（P = 0.02）、LOCS III照片（P = 0.05）和LOCS III评分（P = 0.01），手术眼的白内障进展具有统计学意义。然而，与对侧对照眼相比，根据视力（P = 0.023）和LOCS III评分（P = 0.057）白内障进展显著，但基于LOCS III照片则不显著。手术眼的平均视力下降为2行Snellen视力表；有3例白内障形成或进展但视力未下降。
小梁切除术后白内障似乎会进展；因此，对于晶状体中度混浊的老年患者，可能建议进行联合手术。
