Dang Ya-Long, Wang Xiao, Dai Wan-Wei, Huang Ping, Loewen Nils A, Zhang Chun
Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.
Beijing Key Laboratory of Restoration of Damaged Optic Nerve, Peking University Third Hospital, Beijing 100191, China.
Int J Ophthalmol. 2018 Jun 18;11(6):945-950. doi: 10.18240/ijo.2018.06.08. eCollection 2018.
To evaluate the 2-year efficacy and safety of ab interno trabeculectomy with the Trabectome in Chinese primary open angle glaucoma (POAG) patients.
This was a multicenter, retrospective, observational study and included POAG patients with or without visually-significant cataracts. The Chinese patients were enrolled from three glaucoma centers and a group of comparable Japanese POAG patients was analyzed from our international Trabectome database. The patients received Trabectome or a combined surgery with phacoemulsification and intraocular lens implantation. The primary outcome was intraocular pressure (IOP) reduction. Secondary outcomes included reduction of glaucoma medications, surgical complications, and success at 2y. Success was defined as: 1) IOP≤21 mm Hg and at least 20% IOP reduction from baseline after 3mo at any two consecutive visits; 2) no additional glaucoma surgery required.
A total of 42 Chinese POAG patients from three glaucoma centers were enrolled. Twelve patients underwent Trabectome surgery combined with phacoemulsification and intraocular lens implantation while the remainder underwent Trabectome surgery alone. Thirteen patients had a history of failed glaucoma surgery and were considered as complicated cases. In China data, the mean preoperative IOP was 21.4±1.23 mm Hg. The Trabectome lowered IOP to 17.9±1.8 mm Hg at 2y (=0.05). The number of glaucoma medications also decreased significantly from a baseline of 2.0±0.9 to 1.1±0.8 at 2y post-surgery (=0.04). The overall 2-year success rate was 78%, with patients undergoing combined surgery having a higher success rate compared with those undergoing Trabectome surgery alone (100% 76%). In Japan data, the mean preoperative IOP was 20.8±7.7 mm Hg. The Trabectome lowered IOP to 12.20±2.0 mm Hg at 2y. The number of glaucoma medications also decreased significantly from a baseline of 2.1±0.9 to 3.4±0.6 at 2y post-surgery. In all patients, no major complications were seen.
Surgery with the Trabectome appears to be an efficient and safe procedure in Chinese POAG patients in the long-term.
评估使用Trabectome进行内路小梁切除术治疗中国原发性开角型青光眼（POAG）患者的2年疗效和安全性。
这是一项多中心、回顾性观察研究，纳入了有或无视功能显著白内障的POAG患者。中国患者来自三个青光眼中心，一组可比的日本POAG患者从我们的国际Trabectome数据库中进行分析。患者接受Trabectome手术或联合超声乳化和人工晶状体植入术。主要结局是眼压（IOP）降低。次要结局包括青光眼药物使用减少、手术并发症以及2年时的成功率。成功定义为：1）眼压≤21 mmHg，且在任何连续两次就诊时，3个月后眼压较基线降低至少20%；2）无需额外的青光眼手术。
共纳入来自三个青光眼中心的42例中国POAG患者。12例患者接受了Trabectome手术联合超声乳化和人工晶状体植入术，其余患者仅接受Trabectome手术。13例患者有青光眼手术失败史，被视为复杂病例。在中国的数据中，术前平均眼压为21.4±1.23 mmHg。2年时Trabectome将眼压降至17.9±1.8 mmHg（P=0.05）。青光眼药物数量也从基线的2.0±0.9显著降至术后2年的1.1±0.8（P=0.04）。总体2年成功率为78%，接受联合手术的患者成功率高于仅接受Trabectome手术的患者（100%对76%）。在日本的数据中，术前平均眼压为20.8±7.7 mmHg。2年时Trabectome将眼压降至12.20±2.0 mmHg。青光眼药物数量也从基线的2.1±0.9显著降至术后2年的3.4±0.6。所有患者均未出现重大并发症。
对于中国POAG患者，Trabectome手术长期看来似乎是一种有效且安全的手术方式。
