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EX-PRESS青光眼引流器植入术或小梁切除术后的视力和角膜高阶像差,以及影响视觉功能相关因素的判定

Visual acuity and corneal higher-order aberrations after EX-PRESS or trabeculectomy, and the determination of associated factors that influence visual function.

作者信息

Kobayashi Nobuko, Hirooka Kazuyuki, Nitta Eri, Ukegawa Kaori, Tsujikawa Akitaka

机构信息

Department of Ophthalmology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan.

出版信息

Int Ophthalmol. 2018 Oct;38(5):1969-1976. doi: 10.1007/s10792-017-0685-1. Epub 2017 Aug 10.

Abstract

PURPOSE

This study investigated postoperative visual acuity and corneal higher-order aberrations following EX-PRESS or trabeculectomy.

METHODS

Out of 56 eyes of 56 patients analyzed, 30 eyes were treated using trabeculectomy, while 26 eyes were treated with EX-PRESS. Visual acuity and corneal higher-order aberrations were analyzed in both groups before and at 2 weeks, 1, 2, and 3 months after the surgeries. Risk factors that could potentially influence corneal higher-order aberrations were evaluated.

RESULTS

Significant reductions in the IOP were observed at 3 months after the surgery in both groups. Although a significant decrease in the visual acuity (logMAR) was observed at 2 weeks after the surgery in both groups, at 1 month after the surgeries, there were no significant differences found for the vision as compared to the baseline. At each study visit in the trabeculectomy group, significantly higher corneal higher-order aberrations compared to baseline were noted. In the EX-PRESS group, however, these aberrations were no longer significantly different from the baseline at month 2 (P = 0.36). Analysis of the risk factors indicated that hypotony could influence corneal higher-order aberrations after surgery.

CONCLUSIONS

Corneal higher-order aberrations were significantly increased at 1 month after EX-PRESS treatment, with levels returning to baseline by 2 months. After trabeculectomy, however, corneal higher-order aberrations remained significantly increased at 3 months after the procedure.

摘要

目的

本研究调查了EX-PRESS植入术或小梁切除术后的视力及角膜高阶像差。

方法

在分析的56例患者的56只眼中,30只眼接受小梁切除术治疗,26只眼接受EX-PRESS植入术治疗。在手术前及术后2周、1个月、2个月和3个月对两组患者的视力和角膜高阶像差进行分析。评估可能影响角膜高阶像差的危险因素。

结果

两组患者术后3个月眼压均显著降低。虽然两组患者术后2周时视力(logMAR)均显著下降,但术后1个月时,与基线相比视力无显著差异。在小梁切除术组的每次研究访视中,均发现角膜高阶像差较基线显著升高。然而,在EX-PRESS植入术组中,这些像差在术后2个月时与基线相比不再有显著差异(P = 0.36)。危险因素分析表明,低眼压可能影响术后角膜高阶像差。

结论

EX-PRESS植入术后1个月角膜高阶像差显著增加,至2个月时恢复至基线水平。然而,小梁切除术后,术后3个月角膜高阶像差仍显著增加。

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