Haga Akira, Inatani Masaru, Shobayashi Kohei, Kojima Sachi, Inoue Toshihiro, Tanihara Hidenobu
Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Clin Ophthalmol. 2013;7:1417-21. doi: 10.2147/OPTH.S46375. Epub 2013 Jul 11.
To evaluate the risk factors for choroidal detachment after trabeculectomy with mitomycin C (MMC).
We retrospectively evaluated 420 patients (420 eyes) with glaucoma who underwent trabeculectomy with MMC between June 1, 2005 and December 31, 2010 at Kumamoto University Hospital, Japan. Choroidal detachment after trabeculectomy was defined as a solid-appearing elevation of the retina and choroid. Logistic multivariable analysis was applied to determine the risk factors for choroidal detachment. The following factors were assessed: gender, age, subtypes of glaucoma, eye laterality, history of previous cataract surgery, preoperative intraocular pressure (IOP; mean of three Goldmann applanation readings recorded on different days), postoperative IOP (mean of seven Goldmann applanation readings recorded on 7 consecutive days after trabeculectomy), and postoperative laser suture lysis.
Of the 420 patients, 79 (18.8%) revealed choroidal detachments. The mean period between trabeculectomy and choroidal detachment was 6.1 ± 3.6 days. The mean IOP at the time of the choroidal detachment was 5.5 ± 3.6 mmHg. Age (odds ratio [OR] = 1.028/year, P = 0.0068) and postoperative IOP (OR = 0.887/mmHg, P < 0.0001) were risk factors for choroidal detachment after trabeculectomy. The subgroup analysis for eyes with open angle glaucoma (201 patients) revealed that age (OR = 1.060/year, P = 0.0040) and postoperative IOP (OR = 0.898/mmHg, P = 0.0110) were significant risk factors for choroidal detachment after trabeculectomy with MMC.
Among glaucoma patients, older age and lower postoperative IOP are risk factors for choroidal detachment after trabeculectomy with MMC. In eyes with open angle glaucoma, older age and lower postoperative IOP are risk factors for choroidal detachment after trabeculectomy with MMC.
评估丝裂霉素C（MMC）小梁切除术后脉络膜脱离的危险因素。
我们回顾性评估了2005年6月1日至2010年12月31日期间在日本熊本大学医院接受MMC小梁切除术的420例青光眼患者（420只眼）。小梁切除术后脉络膜脱离定义为视网膜和脉络膜出现实性隆起。采用逻辑多变量分析来确定脉络膜脱离的危险因素。评估了以下因素：性别、年龄、青光眼亚型、患眼侧别、既往白内障手术史、术前眼压（IOP；不同日期记录的三次Goldmann压平眼压测量值的平均值）、术后眼压（小梁切除术后连续7天记录的七次Goldmann压平眼压测量值的平均值）以及术后激光缝线松解。
420例患者中，79例（18.8%）出现脉络膜脱离。小梁切除术至脉络膜脱离的平均时间为6.1±3.6天。脉络膜脱离时的平均眼压为5.5±3.6 mmHg。年龄（比值比[OR]=1.028/年，P=0.0068）和术后眼压（OR=0.887/mmHg，P<0.0001）是小梁切除术后脉络膜脱离的危险因素。开角型青光眼患者（201例）的亚组分析显示，年龄（OR=1.060/年，P=0.0040）和术后眼压（OR=0.898/mmHg，P=0.0110）是MMC小梁切除术后脉络膜脱离的显著危险因素。
在青光眼患者中，年龄较大和术后眼压较低是MMC小梁切除术后脉络膜脱离的危险因素。在开角型青光眼患者中,年龄较大和术后眼压较低是MMC小梁切除术后脉络膜脱离的危险因素。
