Bao Wenjun, Kawase Kazuhide, Huang Hailong, Sawada Akira, Yamamoto Tetsuya
Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, 501-1194, Japan.
BMC Ophthalmol. 2019 Apr 30;19(1):99. doi: 10.1186/s12886-019-1107-0.
To investigate the long-term outcome of trabeculotomy and to compare it with that of trabeculectomy.
We retrospectively reviewed the medical records of patients who had undergone standalone trabeculotomy. Inclusion criteria included a follow-up period of at least 6 years, availability of reliable static visual field results, etc. Age- and preoperative intraocular pressure -matched trabeculectomy cases served as controls. A Kaplan-Meier analysis was employed as a measure of surgical success. Additional clinical factors were also analyzed.
Twenty-five eyes of 25 trabeculotomy patients and 20 eyes of 20 trabeculectomy patients with a mean postoperative follow-up period of 8.0 years were selected. The Kaplan-Meier analysis estimated that the success probability defined as intraocular pressure < 16 mmHg was 44.0 ± 9.9% and 75.0 ± 9.7% at 6 years for trabeculotomy and trabeculectomy, respectively. The final mean deviation significantly progressed in trabeculotomy cases in Central 30-2 programs of the Humphrey Field Analyzer (P = 0.025). Patient characteristics and postoperative clinical data were analyzed by Mann-Whitney's U test and Wilcoxon signed-rank test.
While trabeculotomy was inferior to trabeculectomy in terms of intraocular pressure control and visual field stability in our series, surgical indications should always be determined on an individual basis, pending further research.
研究小梁切开术的长期疗效,并与小梁切除术进行比较。
我们回顾性分析了接受单纯小梁切开术患者的病历。纳入标准包括至少6年的随访期、可靠的静态视野结果等。年龄和术前眼压匹配的小梁切除术病例作为对照。采用Kaplan-Meier分析作为手术成功的衡量标准。还分析了其他临床因素。
选取25例小梁切开术患者的25只眼和20例小梁切除术患者的20只眼,术后平均随访8.0年。Kaplan-Meier分析估计,小梁切开术和小梁切除术在6年时眼压<16 mmHg定义的成功概率分别为44.0±9.9%和75.0±9.7%。在Humphrey视野分析仪的中央30-2程序中,小梁切开术病例的最终平均偏差显著进展(P = 0.025)。通过Mann-Whitney U检验和Wilcoxon符号秩检验分析患者特征和术后临床数据。
在我们的系列研究中,小梁切开术在眼压控制和视野稳定性方面不如小梁切除术,但在进一步研究之前,手术适应症应始终根据个体情况确定。