富克斯异色性葡萄膜炎的原发性青光眼手术：小梁切除术与深层巩膜切除术的比较
Primary glaucoma surgery in Fuchs' heterochromic uveitis: a comparison of trabeculectomy versus deep sclerectomy.
作者信息
Walkden Andrew, Mercieca Karl, Perumal Divya, Anand Nitin
机构信息
Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Eye Unit, Cheltenham and Gloucestershire NHS Foundation Trust, Cheltenham, UK.
出版信息
Ther Adv Ophthalmol. 2019 Aug 19;11:2515841419869761. doi: 10.1177/2515841419869761. eCollection 2019 Jan-Dec.
BACKGROUND
Deep sclerectomy offers the potential advantage of less postoperative inflammation and better survival in Fuchs' patients. The aim of this study was to compare survival and safety profiles of Fuchs' heterochromic uveitis patients undergoing trabeculectomy or deep sclerectomy.
METHODS
A retrospective study was conducted of two separate cohorts who had undergone either trabeculectomy or deep sclerectomy. Patient demographics, best-corrected visual acuity, intraocular pressure, antimetabolite used, postoperative complications and subsequent procedures were analysed.
RESULTS
In total, 13 trabeculectomy patients and 14 deep sclerectomy patients were included. Mean preoperative intraocular pressure was similar at 30.1 mmHg in the trabeculectomy group and 35.9 mmHg in the deep sclerectomy group, with no significant difference between the two ( = 0.22). Kaplan-Meier survival outcomes for success at <22 mmHg and <19 mmHg showed no significant differences between the groups and this was also the case for intraocular pressure at 3 years (analysis of variance; = 0.47).
CONCLUSION
Both procedures appear to have similar efficacy and safety profiles, suggesting that both are effective.
背景
深层巩膜切除术对于富克斯综合征患者具有术后炎症反应较轻及更好的手术成功率的潜在优势。本研究旨在比较接受小梁切除术或深层巩膜切除术的富克斯异色性葡萄膜炎患者的手术成功率及安全性。
方法
对分别接受小梁切除术或深层巩膜切除术的两个独立队列进行回顾性研究。分析患者的人口统计学数据、最佳矫正视力、眼压、使用的抗代谢药物、术后并发症及后续手术情况。
结果
总共纳入了13例接受小梁切除术的患者和14例接受深层巩膜切除术的患者。小梁切除术组术前平均眼压为30.1 mmHg，深层巩膜切除术组为35.9 mmHg，两组之间无显著差异（P = 0.22）。Kaplan-Meier生存分析结果显示，眼压降至<22 mmHg和<19 mmHg时，两组之间无显著差异，3年时的眼压情况也是如此（方差分析；P = 0.47）。
结论
两种手术似乎具有相似的疗效和安全性，表明两者均有效。
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