Esfandiari Hamed, Shah Priyal, Torkian Pooya, Conner Ian P, Schuman Joel S, Hassanpour Kiana, Loewen Nils A
Department of Ophthalmology, School of Medicine, University of Pittsburgh, 203 Lothrop St, Suite 819, Pittsburgh, PA, 15213, USA.
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Graefes Arch Clin Exp Ophthalmol. 2019 Feb;257(2):357-362. doi: 10.1007/s00417-018-4146-y. Epub 2018 Sep 26.
To analyze the 5-year results of trabectome ab interno trabeculectomy of a single glaucoma center.
In this retrospective interventional single-center case series, data of 93 patients undergoing ab interno trabeculotomy between September 2010, and December 2012 were included. Kaplan-Meier analysis was performed using success criteria defined as postoperative intraocular pressure (IOP) ≤ 21 mmHg, and > 20% reduction from preoperative IOP, and no need for further glaucoma surgery. Risk factors for failure were identified using Cox proportional hazards ratio (HR).
The retention rate for 5-year follow-up was 66%. The cumulative probability of success at 1, 2, 3, 4, and 5 years was 82.6%, 76.7%, 73.9%, 72.3%, and 67.5%. Risk factors for failure were lower baseline IOP (HR = 0.27, P = 0.001), younger age (HR = 0.25, P = 0.02), and higher central corneal thickness (HR = 0.18, P = 0.01). Exfoliative glaucoma was associated with a higher success rate (HR = 0.39, P = 0.02). IOP was decreased significantly from 20.0 ± 5.6 mmHg at baseline to 15.6 ± 4.6 mmHg at 5-year follow-up (P = 0.001). The baseline number of glaucoma medications was 1.8 ± 1.2, which decreased to 1.0 ± 1.2 medications at 5 years.
Trabectome surgery was associated with a good long-term efficacy and safety profile in this single-center case series with a high retention rate.
分析单个青光眼中心内路小梁切除术（trabectome）5年的手术效果。
在这个回顾性介入单中心病例系列研究中，纳入了2010年9月至2012年12月期间接受内路小梁切开术的93例患者的数据。采用Kaplan-Meier分析方法，成功标准定义为术后眼压（IOP）≤21 mmHg，较术前眼压降低>20%，且无需进一步的青光眼手术。使用Cox比例风险比（HR）确定失败的危险因素。
5年随访的保留率为66%。1年、2年、3年、4年和5年的累积成功概率分别为82.6%、76.7%、73.9%、72.3%和67.5%。失败的危险因素包括较低的基线眼压（HR = 0.27，P = 0.001）、较年轻的年龄（HR = 0.25，P = 0.02）和较厚的中央角膜厚度（HR = 0.18，P = 0.01）。剥脱性青光眼的成功率较高（HR = 0.39，P = 0.02）。眼压从基线时的20.0±5.6 mmHg显著降低至5年随访时的15.6±4.6 mmHg（P = 0.001）。青光眼药物的基线数量为1.8±1.2种，5年时减少至1.0±1.2种。
在这个保留率高的单中心病例系列中，内路小梁切除术具有良好的长期疗效和安全性。
