Chen Hsin-Yi, Lin Cheng-Li, Kao Chia-Hung
College of Medicine.
Department of Ophthalmology.
Medicine (Baltimore). 2019 Jan;98(4):e14128. doi: 10.1097/MD.0000000000014128.
To determine whether cataract or glaucoma and combined cataract and glaucoma surgery (CGS) affect glaucoma medication usage.We recruited patients who received new diagnoses of glaucoma, either primary open-angle glaucoma (POAG) (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 365.1) or primary angle-closure glaucoma (PACG) (ICD-9-CM code 365.2), between 1998 and 2011 and had undergone cataract surgery alone (CS), glaucoma surgery alone (GS), or CGS under the National Health Insurance program in Taiwan. CS, GS, and CGS in all the patients were performed after the glaucoma diagnosis date. The patients were subdivided into CS, CGS, and GS groups. The number of glaucoma medications, including prostaglandin analogs, β-blockers, carbonic anhydrase inhibitors, α-agonists, pilocarpine, and a combination of drugs, in each prescription, were compared before and after surgery.The mean number of glaucoma medications in each prescription before the surgery increased from approximately 0.5/1 (CS/CGS + GS) to a peak of 1.75/3 within 3 months before the index date. The mean number of glaucoma medications in each prescription reduced to 0 (CS group) and to approximately 0.5 (CGS and GS) at the end of the 3-year follow-up period. The mean number of glaucoma medications in each prescription significantly reduced at the time points within 6 months, between 6 months and 2 years, and during 2 to 3 years after surgery in each group. At the end of the 3-year period, the reduction effect was most evident in the CS group. Similar trends were also observed in the POAG and PACG group.CS, GS, and CGS significantly reduced the number of glaucoma medications used by the glaucoma patients.
为确定白内障或青光眼以及白内障合并青光眼手术(CGS)是否会影响青光眼药物的使用。我们招募了1998年至2011年间新诊断为青光眼的患者,包括原发性开角型青光眼(POAG)(国际疾病分类第九版临床修订本[ICD-9-CM]编码365.1)或原发性闭角型青光眼(PACG)(ICD-9-CM编码365.2),且这些患者在台湾国民健康保险计划下接受了单纯白内障手术(CS)、单纯青光眼手术(GS)或CGS。所有患者的CS、GS和CGS均在青光眼诊断日期之后进行。将患者分为CS组、CGS组和GS组。比较每组患者术前和术后每张处方中青光眼药物的数量,包括前列腺素类似物、β受体阻滞剂、碳酸酐酶抑制剂、α激动剂、毛果芸香碱以及联合用药。术前每张处方中青光眼药物的平均数量从约0.5/1(CS/CGS + GS)增加到索引日期前3个月内的峰值(1.75/3)。在3年随访期结束时,每张处方中青光眼药物的平均数量在CS组降至0,在CGS组和GS组降至约0.5。每组患者在术后6个月内、6个月至2年之间以及2至3年期间,每张处方中青光眼药物的平均数量均显著减少。在3年期末,CS组的减少效果最为明显。在POAG组和PACG组中也观察到了类似趋势。CS、GS和CGS均显著减少了青光眼患者使用的青光眼药物数量。