Sato Tomoki, Kawaji Takahiro, Hirata Akira, Mizoguchi Takanori
Sato Eye and Internal Medicine Clinic, Arao City, Kumamoto, Japan.
Hayashi Eye Hospital, Hakata-ku, Fukuoka, Japan.
Clin Ophthalmol. 2018 May 17;12:915-923. doi: 10.2147/OPTH.S161238. eCollection 2018.
The purpose of this study was to evaluate the efficacy of 360-degree suture trabeculotomy (360S-LOT) ab interno for treating open-angle glaucoma (OAG). Risk factors of surgical failure were examined.
360S-LOT ab interno alone was performed for patients with uncontrolled OAG, and combined 360S-LOT ab interno/phacoemulsification was performed for patients with controlled OAG with a visually significant cataract between March 2014 and September 2015 at a single center. The patients were prospectively followed for 2 years. The main outcome measures included 2-year intraocular pressure (IOP), number of anti-glaucoma medications used, postoperative complications, and predictive factors of surgical failure. Kaplan-Meier analysis was performed, with surgical success (with or without medication use) defined as postoperative IOP ≤15 mmHg and IOP reduction ≥20% (criterion A) or IOP ≤12 mmHg and IOP reduction ≥30% (criterion B). Predictive factors were evaluated using Cox proportional hazard ratios.
A total of 64 eyes of 64 patients were included, and 50 (78%) eyes of 64 eyes underwent a phacoemulsification combination procedure. Surgery significantly reduced IOP from 18.4 ± 2.9 mmHg before surgery to 13.4 ± 3.0 mmHg after surgery ( < 0.001). Patients used an average of 1.8 ± 1.5 medications before surgery and 1.3 ± 1.5 medications after surgery ( = 0.101). No serious postoperative complications were observed. The probability of surgical success was 49.2% and 16.0% using criteria A and B, respectively. No risk factors of surgical failure were identified.
The 360S-LOT ab interno procedure is a favorable option for treating eyes with mild or moderate OAG.
本研究旨在评估内路360度小梁切开术（360S-LOT）治疗开角型青光眼（OAG）的疗效。研究手术失败的危险因素。
2014年3月至2015年9月在单一中心，对眼压控制不佳的OAG患者单独施行内路360S-LOT，对眼压控制良好且伴有具有临床意义的白内障的OAG患者施行内路360S-LOT联合超声乳化术。对患者进行前瞻性随访2年。主要观察指标包括2年眼压（IOP）、抗青光眼药物使用数量、术后并发症以及手术失败的预测因素。采用Kaplan-Meier分析，手术成功（无论是否使用药物）定义为术后眼压≤15 mmHg且眼压降低≥20%（标准A）或眼压≤12 mmHg且眼压降低≥30%（标准B）。使用Cox比例风险比评估预测因素。
共纳入64例患者的64只眼，其中64只眼中50只眼（78%）接受了超声乳化联合手术。手术使眼压从术前的18.4±2.9 mmHg显著降至术后的13.4±3.0 mmHg（P<0.001）。患者术前平均使用1.8±1.5种药物，术后平均使用1.3±1.5种药物（P=0.101）。未观察到严重的术后并发症。采用标准A和标准B时，手术成功的概率分别为49.2%和16.0%。未发现手术失败的危险因素。
内路360S-LOT手术是治疗轻、中度OAG眼的理想选择。
