Chan Li-Wei, Hsu Wei-Cherng, Hsieh Yi-Ting
*Department of Ophthalmology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei†School of Medicine, Tzu Chi University, Hualien‡Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
J Glaucoma. 2016 Mar;25(3):e268-72. doi: 10.1097/IJG.0000000000000296.
To report the control of intraocular pressure (IOP) after removal of subtenon triamcinolone acetonide (TA) plaques in patients with uncontrolled ocular hypertension after posterior subtenon injection of triamcinolone acetonide (PSTA) and to evaluate the factors associated with rapid IOP normalization after subtenon TA removal.
Data from 8 eyes of 7 patients receiving excision of subtenon TA plaques for uncontrolled ocular hypertension after PSTA in 1 hospital from June 2010 to December 2012 were retrospectively collected. The percentage of IOP lowering on postoperative day 1 and the time to IOP normalization after subtenon TA removal were reported. Pearson correlation analysis was used to analyze the factors for rapid IOP normalization after subtenon TA removal.
The IOP lowering on postoperative day 1 ranged from 12% to 75%. All cases achieved IOP normalization within a mean of 2.5±1.9 days (range, 1 to 5 d) after subtenon TA removal. Fewer kinds of antiglaucoma agents used before subtenon TA removal was associated with greater IOP lowering on postoperative day 1 (P=0.01) and more rapid return to normal IOP (P=0.01). Older age and more time from PSTA to ocular hypertension were both correlated with shorter time to achieve IOP normalization after operation (P=0.01 and 0.02, respectively).
In medically uncontrolled ocular hypertension after PSTA, excision of subtenon TA plaques provided IOP normalization as rapidly as 1 to 5 days. Fewer preoperative antiglaucoma agents, older age, and more time from PSTA to ocular hypertension were correlated with more rapid IOP normalization after subtenon TA removal.
报告在接受后Tenon囊下注射曲安奈德（PSTA）后眼压控制不佳的患者中，切除Tenon囊下曲安奈德（TA）斑块后眼内压（IOP）的控制情况，并评估Tenon囊下TA切除术后眼压快速恢复正常的相关因素。
回顾性收集2010年6月至2012年12月在1家医院接受Tenon囊下TA斑块切除以治疗PSTA后眼压控制不佳的7例患者的8只眼的数据。报告术后第1天眼压降低的百分比以及Tenon囊下TA切除术后眼压恢复正常的时间。采用Pearson相关性分析来分析Tenon囊下TA切除术后眼压快速恢复正常的因素。
术后第1天眼压降低幅度为12%至75%。所有病例在Tenon囊下TA切除术后平均2.5±1.9天（范围1至5天）内眼压恢复正常。Tenon囊下TA切除术前使用的抗青光眼药物种类较少与术后第1天更大的眼压降低幅度相关（P=0.01），且眼压更快恢复正常（P=0.01）。年龄较大以及从PSTA到眼压升高的时间较长均与术后眼压恢复正常的时间较短相关（分别为P=0.01和0.02）。
在PSTA后药物治疗无法控制的眼压升高患者中，切除Tenon囊下TA斑块可使眼压在1至5天内迅速恢复正常。术前抗青光眼药物种类较少、年龄较大以及从PSTA到眼压升高的时间较长与Tenon囊下TA切除术后眼压更快恢复正常相关。
