原发性开角型青光眼患者中行超声乳化联合内镜睫状体光凝术与单纯超声乳化术的对比研究

Phacoemulsification plus endoscopic cyclophotocoagulation versus phacoemulsification alone in primary open-angle glaucoma.

作者信息

Pérez Bartolomé Francisco, Rodrigues Ian A, Goyal Saurabh, Bloch Edward, Lim Wei S, Alaghband Pouya, Guajardo Jose, Jones Stephanie, Lim Kin S

机构信息

1 Department of Ophthalmology, Hospital Clínico San Carlos, Madrid - Spain.

2 Department of Ophthalmology, St. Thomas' Hospital NHS Foundation Trust, London - UK.

出版信息

Eur J Ophthalmol. 2018 Mar;28(2):168-174. doi: 10.5301/ejo.5001034.

DOI:10.5301/ejo.5001034

PMID:29077182

Abstract

PURPOSE

To examine the efficacy and safety of combined phacoemulsification and endoscopic cyclophotocoagulation (phaco-ECP) compared to phacoemulsification alone in patients with primary open-angle glaucoma (POAG).

METHODS

We performed a retrospective notes review of 99 consecutive clinical records of patients with POAG from 2 London eye departments. A total of 69 patients who underwent phaco-ECP and 30 sex- and age-matched control patients who underwent cataract surgery alone were included. Data on intraocular pressure (IOP), visual acuity (VA), number of ocular hypotensive medications, and postoperative complications were collected over 12 months. The primary outcome measure was defined as an IOP within normal limits (<21 mm Hg) and at least a 20% reduction in IOP from baseline.

RESULTS

Mean IOP was significantly decreased in both groups after 1 year (p<0.001 from baseline). The success rate was significantly higher in the phaco-ECP group (69.6%) than in the phaco group (40%) after 1 year (p = 0.004). Reduction in mean IOP and number of medications was also greater in the phaco-ECP group after 1 year (IOP reduction: 4.5 ± 5.13 mm Hg vs 1.83 ± 3.61 mm Hg; p = 0.007; number of medications reduction: 0.73 ± 0.71 vs 0.23 ± 0.56; p = 0.001). Both groups achieved a similar improvement in VA. There was a higher incidence of minor and self-limiting complications in the phaco-ECP group (p<0.047).

CONCLUSIONS

Phaco-ECP resulted in a greater reduction in IOP and number of medications than phacoemulsification alone in POAG.

摘要

目的

比较超声乳化联合内镜睫状体光凝术（phaco - ECP）与单纯超声乳化术治疗原发性开角型青光眼（POAG）患者的疗效和安全性。

方法

我们对来自伦敦两个眼科科室的99例POAG患者的连续临床记录进行了回顾性分析。共纳入69例行phaco - ECP的患者和30例年龄及性别匹配的单纯接受白内障手术的对照患者。收集了12个月内的眼压（IOP）、视力（VA）、降眼压药物使用数量及术后并发症的数据。主要结局指标定义为眼压在正常范围内（<21 mmHg）且眼压较基线至少降低20%。

结果

两组患者1年后平均眼压均显著降低（与基线相比p<0.001）。1年后，phaco - ECP组的成功率（69.6%）显著高于单纯超声乳化组（40%）（p = 0.004）。1年后phaco - ECP组平均眼压降低幅度和药物使用数量减少幅度也更大（眼压降低：4.5±5.13 mmHg对1.83±3.61 mmHg；p = 0.007；药物使用数量减少：0.73±0.71对0.23±0.56；p = 0.001）。两组患者视力改善情况相似。phaco - ECP组轻微和自限性并发症的发生率更高（p<0.047）。