Department of Ophthalmology, Institute of Surgery Research, Daping Hospital.
Department of Ophthalmology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
J Glaucoma. 2018 Oct;27(10):906-909. doi: 10.1097/IJG.0000000000001056.
To assess the safety and efficacy of CO2 laser-assisted sclerectomy surgery (CLASS) combined with phacoemulsification in patients with primary open-angle glaucoma (POAG) and visually significant cataracts.
This was a prospective, uncontrolled, interventional case series. Seventeen patients (17 eyes) diagnosed with POAG and cataracts were enrolled starting from November 2015. All subjects underwent CLASS combined with phacoemulsification surgery by the same surgeon. After the surgery, all patients were followed for 12 months. The preoperative to postoperative changes in intraocular pressure (IOP), glaucoma medication requirements, best-corrected visual acuity and adverse events were recorded.
The results of 17 eyes of 17 patients were included in the statistical analysis. The baseline mean IOP was 23.94±8.57 mm Hg (mean±SD), and patients used 2.18±0.88 types of antiglaucoma medication. At 12 months postsurgery, the mean IOP was 14.67±2.97 mm Hg, and patients used 0.59±0.87 types of antiglaucoma medication (both P<0.001). The logarithm of the minimal angle of resolution of the best-corrected visual acuity improved from 0.77±0.42 preoperatively to 0.33±0.47 postoperatively (P<0.05). Two patients experienced intraoperative perforation accompanied by iris prolapse. One patient exhibited postoperative choroidal detachment.
CLASS with phacoemulsification may become a safe and effective intervention for patients with POAG and visually significant cataracts.
评估 CO2 激光辅助巩膜切除术（CLASS）联合超声乳化术治疗原发性开角型青光眼（POAG）合并明显视力障碍性白内障的安全性和有效性。
这是一项前瞻性、非对照、干预性病例系列研究。自 2015 年 11 月起，共纳入 17 名（17 只眼）被诊断为 POAG 合并白内障的患者。所有患者均由同一位外科医生行 CLASS 联合超声乳化术。术后所有患者均随访 12 个月，记录术前至术后眼压（IOP）、青光眼药物需求、最佳矫正视力和不良事件的变化情况。
共纳入 17 名患者 17 只眼的结果进行统计分析。基线时平均 IOP 为 23.94±8.57 mm Hg（均值±标准差），患者使用 2.18±0.88 种抗青光眼药物。术后 12 个月时，平均 IOP 为 14.67±2.97 mm Hg，患者使用 0.59±0.87 种抗青光眼药物（均 P<0.001）。最佳矫正视力的最小分辨角对数从术前的 0.77±0.42 提高到术后的 0.33±0.47（P<0.05）。2 例患者术中发生巩膜穿孔伴虹膜脱出，1 例患者术后发生脉络膜脱离。
CLASS 联合超声乳化术可能成为 POAG 合并明显视力障碍性白内障患者安全有效的治疗选择。
