Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, Japan.
Jpn J Ophthalmol. 2013 Nov;57(6):514-9. doi: 10.1007/s10384-013-0257-5. Epub 2013 Aug 3.
To evaluate the prognostic factors for surgical outcomes of subsequent trabeculectomy with mitomycin C (MMC) after prior incisional glaucoma surgery.
We reviewed medical records of a total cohort of 781 trabeculectomies with MMC, and selected 125 patients (125 eyes). The primary endpoints included persistent intraocular pressure (IOP) of ≥21 or <5 mmHg, the need for additional glaucoma surgery and deterioration of visual acuity to no light perception. Univariate and Multivariate analyses were performed by using the Cox proportional hazards model.
The mean follow-up period was 26.8 months. The probabilities of success at 1, 2, and 3 years were 80.6, 72.2, and 70.6 %, respectively. Multivariate analysis showed that a shorter time interval between prior glaucoma surgery and subsequent trabeculectomy [relative risk (RR), 0.8867/year; P = 0.0090] and the number of prior trabeculectomies (RR, 2.2645; P = 0.0029) were significant prognostic factors for subsequent failure of trabeculectomy with MMC.
A short time period between prior glaucoma surgery and subsequent trabeculectomy and the number of prior trabeculectomies are associated with surgical failure of subsequent trabeculectomy with MMC.
评估在先前的切开性青光眼手术后，用丝裂霉素 C（MMC）进行后续小梁切除术的手术结果的预后因素。
我们回顾了总共 781 例 MMC 小梁切除术的病历，并选择了 125 例患者（125 只眼）。主要终点包括持续性眼内压（IOP）≥21mmHg 或＜5mmHg、需要额外的青光眼手术以及视力恶化至无光感。采用 Cox 比例风险模型进行单因素和多因素分析。
平均随访时间为 26.8 个月。1、2、3 年的成功率分别为 80.6%、72.2%和 70.6%。多因素分析显示，先前青光眼手术和后续小梁切除术之间的时间间隔较短[相对风险（RR），0.8867/年；P=0.0090]以及先前小梁切除术的数量（RR，2.2645；P=0.0029）是后续 MMC 小梁切除术失败的显著预后因素。
先前青光眼手术和后续小梁切除术之间的时间间隔较短以及先前小梁切除术的数量与后续 MMC 小梁切除术的手术失败相关。
