Tojo Naoki, Abe Shinya, Miyakoshi Mari, Hayashi Atsushi
Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
Clin Ophthalmol. 2017 Sep 14;11:1667-1675. doi: 10.2147/OPTH.S143061. eCollection 2017.
Ab interno trabeculectomy (AIT) with the Trabectome has been shown to reduce intraocular pressure (IOP) in eyes with pseudoexfoliation (PEX) glaucoma. Here, we examined the change of IOP fluctuations before and after only AIT or AIT with cataract surgery in PEX patients using the contact lens sensor Triggerfish.
This was a prospective open-label study. Twenty-four consecutive patients with PEX glaucoma were included. Twelve patients underwent cataract surgery and AIT (triple-surgery group), and 12 patients underwent only AIT (single-surgery group). In each eye, IOP fluctuations over 24 h were measured with the contact lens sensor before and at 3 months after the surgery. We compared the change of IOP fluctuation before and after operation. We also evaluated the difference in IOP changes between the triple- and single-surgery groups.
At 3 months after the surgeries, the mean IOP was significantly reduced from 23.5±6.5 mmHg to 14.6±2.8 mmHg in the single-surgery group and from 22.5±3.0 mmHg to 11.5±2.9 mmHg in the triple-surgery group. The mean IOP reduction rate was significantly higher in the triple-surgery group compared to the single-surgery group (=0.0358). In both groups, the mean range of IOP fluctuations was significantly decreased during nocturnal periods. The mean range of 24 h IOP fluctuations was decreased in the triple-surgery group (=0.00425), not in the single-surgery group (=0.970).
Triple surgery could decrease IOP value and the IOP fluctuations to a greater extent than single surgery in PEX glaucoma patients.
已证明使用 Trabectome 进行内路小梁切除术（AIT）可降低剥脱性（PEX）青光眼患者的眼压（IOP）。在此，我们使用隐形眼镜传感器 Triggerfish 检查了仅接受 AIT 或接受 AIT 联合白内障手术的 PEX 患者手术前后眼压波动的变化。
这是一项前瞻性开放标签研究。纳入了 24 例连续的 PEX 青光眼患者。12 例患者接受了白内障手术和 AIT（三联手术组），12 例患者仅接受了 AIT（单手术组）。在每只眼中，术前和术后 3 个月使用隐形眼镜传感器测量 24 小时眼压波动情况。我们比较了手术前后眼压波动的变化。我们还评估了三联手术组和单手术组之间眼压变化的差异。
手术后 3 个月，单手术组的平均眼压从 23.5±6.5 mmHg 显著降至 14.6±2.8 mmHg，三联手术组从 22.5±3.0 mmHg 降至 11.5±2.9 mmHg。三联手术组的平均眼压降低率显著高于单手术组（=0.0358）。在两组中，夜间眼压波动的平均范围均显著降低。三联手术组 24 小时眼压波动的平均范围降低（=0.00425），单手术组未降低（=0.970）。
在 PEX 青光眼患者中，三联手术比单手术能更大程度地降低眼压值和眼压波动。
