Senthil Sirisha, Chinta Supriya, Rao Harsha L, Choudhari Nikhil S, Pathak-Ray Vanita, Mandal Anil K, Garudadri Chandra S
*VST Glaucoma Centre †Centre for Clinical Epidemiology and Biostatistics, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India.
J Glaucoma. 2016 Mar;25(3):e209-13. doi: 10.1097/IJG.0000000000000229.
To compare the outcomes of cataract surgery alone versus combined cataract surgery with trabeculectomy in eyes with phacomorphic glaucoma.
In a retrospective comparative case series, 126 eyes of phacomorphic glaucoma presenting within 4 weeks of onset between 1993 and 2012, with at least 6 months of postoperative follow-up were included. Group 1 included 63 eyes with cataract surgery only and group 2 included 63 eyes with combined cataract surgery and trabeculectomy. Primary outcome measure was intraocular pressure (IOP) ≤21 mm Hg (without antiglaucoma medication) 6 months after surgery.
The median (interquartile range) preoperative IOP in group 1 was 36 mm Hg (30 to 50 mm Hg) and group 2 was 40 mm Hg (32 to 48 mm Hg) (P=0.34). The median duration of phacomorphic attack was 7 days (3 to 12 d) in group 1 and 7 days (3 to 15 d) in group 2 (P=0.39). The median duration of postoperative follow-up was 23 months in group 1 and 30 months in group 2 (P=0.89). Six months after surgery, 97% of the eyes in group 1 and 100% in group 2 achieved IOP≤21 mm Hg without antiglaucoma medications with a median postoperative IOP of 12 mm Hg in both the groups (P=0.09). The median Log MAR visual acuity was significantly better in group 1 compared with group 2 (0.2 vs. 0.3, P<0.001). The percentage of eyes that achieved visual acuity better than 20/40 at 3 months was 62% in group 1 versus 19% in group 2 and at 6 months it was 75% in group 1 versus 38% in group 2 (P<0.001).
In our cohort of phacomorphic glaucoma presenting within 4 weeks of onset, cataract surgery and combined surgery resulted in similar IOP control at 6 months. However, cataract surgery alone resulted in better and faster visual recovery.
比较晶状体膨胀性青光眼患者单纯白内障手术与白内障手术联合小梁切除术的疗效。
在一项回顾性比较病例系列研究中，纳入了1993年至2012年间发病4周内就诊的126例晶状体膨胀性青光眼患者，术后随访至少6个月。第1组包括63例行单纯白内障手术的患眼，第2组包括63例行白内障手术联合小梁切除术的患眼。主要观察指标为术后6个月眼压（IOP）≤21 mmHg（未使用抗青光眼药物）。
第1组术前眼压中位数（四分位间距）为36 mmHg（30至50 mmHg），第2组为40 mmHg（32至48 mmHg）（P = 0.34）。第1组晶状体膨胀发作的中位持续时间为7天（3至12天），第2组为7天（3至15天）（P = 0.39）。第1组术后随访的中位时间为23个月，第2组为30个月（P = 0.89）。术后6个月，第1组97%的患眼和第2组100%的患眼在未使用抗青光眼药物的情况下眼压≤21 mmHg，两组术后眼压中位数均为12 mmHg（P = 0.09）。第1组的平均Log MAR视力明显优于第2组（0.2对0.3，P<0.001）。第1组在3个月时视力优于20/40的患眼百分比为62%，第2组为19%；在6个月时，第1组为75%，第2组为38%（P<0.001）。
在我们的发病4周内就诊的晶状体膨胀性青光眼队列中，白内障手术和联合手术在6个月时眼压控制效果相似。然而，单纯白内障手术能带来更好、更快的视力恢复。
