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使用 Trabectome 行内路小梁切开术联合或不联合白内障手术治疗高眼压开角型青光眼患者的短期临床结果

Short-Term Clinical Results of Ab Interno Trabeculotomy Using the Trabectome with or without Cataract Surgery for Open-Angle Glaucoma Patients of High Intraocular Pressure.

作者信息

Akil Handan, Chopra Vikas, Huang Alex S, Swamy Ramya, Francis Brian A

机构信息

Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, CA, USA.

Department of Ophthalmology, David Geffen School of Medicine, Los Angeles, CA, USA.

出版信息

J Ophthalmol. 2017;2017:8248710. doi: 10.1155/2017/8248710. Epub 2017 Apr 17.

Abstract

. To assess the safety and efficacy of Trabectome procedure in patients with preoperative intraocular pressure (IOP) of 30 mmHg or higher. . All patients who had underwent Trabectome stand-alone or Trabectome combined with phacoemulsification were included. Survival analysis was performed by using Kaplan-Meier, and success was defined as IOP ≤ 21 mmHg, 20% or more IOP reduction from baseline for any two consecutive visits after 3 months, and no secondary glaucoma surgery. . A total of 49 cases were included with an average age of 66 (range: 13-91). 28 cases had Trabectome stand-alone and 21 cases had Trabectome combined with phacoemulsification. Mean IOP was reduced from a baseline of 35.6 ± 6.3 mmHg to 16.8 ± 3.8 mmHg at 12 months ( < 0.01), while the number of medications was reduced from 3.1 ± 1.3 to 1.8 ± 1.4 ( < 0.01). Survival rate at 12 months was 80%. 9 cases required secondary glaucoma surgery, and 1 case was reported with hypotony at day one, but resolved within one week. . Trabectome seems to be safe and effective in patients with preoperative IOP of 30 mmHg or greater. Even in this cohort with high preoperative IOP, the end result is a mean IOP in the physiologic range.

摘要

评估Trabectome手术在术前眼压(IOP)为30 mmHg或更高的患者中的安全性和有效性。纳入所有接受单独Trabectome手术或Trabectome联合超声乳化手术的患者。采用Kaplan-Meier法进行生存分析,成功定义为眼压≤21 mmHg、术后3个月任何连续两次随访时眼压较基线降低20%或更多,且未进行二次青光眼手术。共纳入49例患者,平均年龄66岁(范围:13 - 91岁)。28例接受单独Trabectome手术,21例接受Trabectome联合超声乳化手术。12个月时平均眼压从基线的35.6±6.3 mmHg降至16.8±3.8 mmHg(P<0.01),而药物数量从3.1±1.3降至1.8±1.4(P<0.01)。12个月时生存率为80%。9例需要二次青光眼手术,1例在术后第1天出现低眼压,但在1周内缓解。Trabectome手术在术前眼压为30 mmHg或更高的患者中似乎是安全有效的。即使在这个术前眼压较高的队列中,最终结果是平均眼压处于生理范围内。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6c8/5412169/7a5f842cadd0/JOPH2017-8248710.001.jpg

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