Iwasaki Kentaro, Takamura Yoshihiro, Arimura Shogo, Tsuji Takahiro, Matsumura Takehiro, Gozawa Makoto, Inatani Masaru
Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan.
J Ophthalmol. 2019 Aug 7;2019:4731653. doi: 10.1155/2019/4731653. eCollection 2019.
We prospectively evaluated refractive changes in the eyes of 97 patients who underwent trabeculectomy at Fukui University Hospital, Fukui, Japan. The primary outcome measure was the refractive change after trabeculectomy. Secondary outcome measures included postoperative complications and prognostic factors for refractive change. We observed a progressive and significant mean refractive myopic shift of -0.80 D at 12 months after surgery. In phakic eyes, the mean myopic refractive shifts progressed significantly by -0.46 D at 3 months after surgery (=0.003), by -0.52 D at 6 months (=0.012), and by -1.31 D at 12 months ( < 0.001). In the pseudophakic eyes, we found no significant refraction progression at any of the postsurgery follow-up visits. Our multivariable analyses showed that lens nuclear color grade change was a significant prognostic factor for refractive myopic progression ( < 0.001). Trabeculectomy causes refractive myopic progression in phakic eyes. Nuclear sclerotic cataract progression is associated with refractive myopic shift after trabeculectomy. This trail is registered with UMIN000007813.
我们对日本福井县福井大学医院接受小梁切除术的97例患者的眼部屈光变化进行了前瞻性评估。主要观察指标是小梁切除术后的屈光变化。次要观察指标包括术后并发症和屈光变化的预后因素。我们观察到术后12个月平均屈光近视移位逐渐且显著，为-0.80 D。在有晶状体眼中，术后3个月平均近视屈光移位显著进展-0.46 D（P = 0.003），6个月时为-0.52 D（P = 0.012），12个月时为-1.31 D（P < 0.001）。在人工晶状体眼中，术后任何随访时间均未发现明显的屈光进展。我们的多变量分析表明，晶状体核颜色分级变化是屈光性近视进展的一个重要预后因素（P < 0.001）。小梁切除术会导致有晶状体眼出现屈光性近视进展。核性硬化性白内障进展与小梁切除术后的屈光性近视移位有关。本试验已在UMIN000007813注册。
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