闭角型青光眼未行药物治疗的超声乳化术后眼压变化。

Intraocular pressure change after phacoemulsification in angle-closure eyes without medical therapy.

机构信息

From the Singapore Eye Research Institute (Atalay, Nongpiur, Baskaran, Perera, Wong, Aung), the Duke-NUS Graduate Medical School (Nongpiur, Baskaran, Wong), the Yong Loo Lin School of Medicine (Aung), National University of Singapore, and the Singapore National Eye Centre (Perera, Wong, Quek, Aung), Singapore, Singapore.

出版信息

J Cataract Refract Surg. 2017 Jun;43(6):767-773. doi: 10.1016/j.jcrs.2017.03.031.

DOI:10.1016/j.jcrs.2017.03.031

PMID:28732610

Abstract

PURPOSE

To evaluate the intraocular pressure (IOP) change and associated factors 6 months after phacoemulsification in eyes with primary angle-closure suspect (PACS) and eyes with primary angle closure (PAC) that had no medical therapy.

SETTING

Singapore National Eye Center, Singapore, Singapore.

DESIGN

Retrospective case series.

METHODS

Patients with PACS or PAC (with corrected distance visual acuity <20/40) who had uneventful phacoemulsification were recruited. Patients were excluded if they were on IOP-lowering medications within 6 months preoperatively and postoperatively. Preoperative gonioscopy, A-scan biometry, anterior segment optical coherence tomography, and automated refraction were reviewed. Factors related to the percentage of and absolute IOP change were assessed using multiple linear regression analyses after adjusting for age, sex, and diagnosis.

RESULTS

The study evaluated 85 patients (85 eyes; 52 PACS, 33 PAC) after 7 eyes (1 PACS, 6 PAC) were excluded because of poor quality imaging. Overall, IOP decreased by 19.9% from the preoperative mean of 16.1 mm Hg ± 3.1 (SD) to 12.9 ± 2.7 mm Hg. The IOP change between the PACS group (-3.3 ± 2.8 mm Hg; -20.6%) and the PAC group (-3.2 ± 4.7 mm Hg; -19.6%) was similar (P > .05). In multiple linear regression analyses, a higher preoperative IOP (β = 0.68, P < .001) and fewer clock hours of peripheral anterior synechiae (PAS) (β = -0.30, P = .03) predicted a greater absolute change in and percentage of reduction in IOP, respectively.

CONCLUSIONS

The mean IOP reduction 6 months after phacoemulsification was 20%. Less IOP reduction was observed in the presence of lower preoperative IOP and more extensive PAS.

摘要

目的

评估原发性闭角型青光眼可疑患者（PACS）和原发性闭角型青光眼（PAC）行超声乳化白内障吸除术后 6 个月的眼压（IOP）变化及其相关因素。

设置

新加坡国家眼科中心，新加坡。

设计

回顾性病例系列。

方法

纳入无眼部治疗的 PACS 或 PAC 患者（矫正视力<20/40）。如果患者在术前和术后 6 个月内使用了降眼压药物，则将其排除。回顾术前房角镜检查、A 型超声生物测量、眼前节光学相干断层扫描和自动验光结果。采用多元线性回归分析，在调整年龄、性别和诊断后，评估与眼压变化百分比和绝对变化相关的因素。

结果

本研究共评估了 85 例患者（85 只眼；52 例 PACS，33 例 PAC），其中 7 例患者（1 例 PACS，6 例 PAC）因图像质量差而被排除。总体而言，IOP 从术前平均 16.1 ± 3.1mmHg 降至 12.9 ± 2.7mmHg，降低了 19.9%。PACS 组（-3.3 ± 2.8mmHg；-20.6%）和 PAC 组（-3.2 ± 4.7mmHg；-19.6%）之间的 IOP 变化相似（P>.05）。多元线性回归分析显示，术前较高的 IOP（β=0.68，P<.001）和较少的周边前房粘连（PAS）时钟小时数（β=-0.30，P=.03）分别预测眼压绝对值和百分比的变化。