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青光眼手术后 90 天内并发症的再次手术。

Reoperations for Complications Within 90 Days After Glaucoma Surgery.

机构信息

Columbia University Medical Center, Harkness Eye Institute.

New York University (NYU) School of Medicine, NYU Langone Health, New York, NY.

出版信息

J Glaucoma. 2020 May;29(5):344-346. doi: 10.1097/IJG.0000000000001484.

Abstract

OBJECTIVE

To describe reoperations in the operating room for complications encountered within 90 days after glaucoma surgery at a single institution over a 2-year period.

DESIGN

Retrospective case series.

SUBJECTS

Adult patients who have undergone glaucoma surgery including a tube shunt, trabeculectomy with mitomycin C, trabectome, or transcleral cyclophotocoagulation from June 1, 2015 to August 30, 2017 at a single institution.

METHODS

These patients were then examined for postoperative complications that required reoperations within the first 90 days including revision of the tube shunt, revision of the trabeculectomy, drainage of the choroidal, or placement of a tube shunt.

MAIN OUTCOME MEASURES

Percentage of reoperations for complications within the first 90 days after glaucoma surgery and surgical indications for these reoperations.

RESULTS

A total of 622 glaucoma procedures were performed on 600 eyes in 525 patients over a 2-year period from June 1, 2015 to June 30, 2017 by 4 glaucoma surgeons at a single institution. Of these, 275 (44%) were trabeculectomy with mitomycin C, 253 (41%) were the placement of a tube shunt, 33 (5%) were cyclophotocoagulation, and 61 (10%) were trabectome procedures. Postoperative complications requiring reoperations within 90 days developed in 15 patients (2.4%) overall including 7 patients (2.5%) in the trabeculectomy with mitomycin C group and 8 patients (3.1%) in the tube shunt group. Five patients developed bleb leaks, 3 patients developed serous choroidal effusions, 3 patients had tube exposure, 1 patient had tube retraction, 1 patient had persistent iritis from iris touching the tube, and 1 had encapsulation around the tube. The rate of reoperation for complications was similar between the tube group and the trabeculectomy group (P=0.67, χ test). There were no complications requiring reoperations in 90 days for transcleral cyclophotocoagulation or trabectome.

CONCLUSIONS

Early postoperative complications requiring reoperations within the first 90 days after glaucoma surgery were low and comparable with previous studies. Common indications for reoperation within 90 days include wound leak and tube shunt-related issues.

摘要

目的

描述在单家机构的 2 年期间内,在青光眼手术后 90 天内发生的并发症,并在手术室进行再次手术的情况。

设计

回顾性病例系列研究。

研究对象

2015 年 6 月 1 日至 2017 年 8 月 30 日期间,在单家机构接受青光眼手术的成年患者,包括管分流术、丝裂霉素 C 小梁切除术、小梁切除术或经巩膜睫状体光凝术。

方法

这些患者随后检查术后并发症,包括在术后 90 天内需要再次手术的情况,包括管分流术的修正、小梁切除术的修正、脉络膜引流或管分流术的放置。

主要观察指标

青光眼手术后 90 天内再次手术的并发症发生率,以及这些再次手术的手术指征。

结果

在 2 年期间内(2015 年 6 月 1 日至 2017 年 6 月 30 日),由 4 位青光眼外科医生在单家机构对 525 例患者的 600 只眼进行了总共 622 次青光眼手术。其中,275 例(44%)为丝裂霉素 C 小梁切除术,253 例(41%)为管分流术,33 例(5%)为睫状体光凝术,61 例(10%)为小梁切除术。总体而言,有 15 例(2.4%)患者在术后 90 天内出现需要再次手术的并发症,包括丝裂霉素 C 小梁切除术组的 7 例(2.5%)和管分流术组的 8 例(3.1%)。5 例患者出现了滤泡漏,3 例患者出现了浆液性脉络膜渗漏,3 例患者出现了管暴露,1 例患者出现了管回缩,1 例患者出现了管接触虹膜导致的持续性虹膜炎,1 例患者出现了管周围包裹。管组和小梁切除术组的并发症再次手术率相似(P=0.67,卡方检验)。90 天内无需再次手术治疗经巩膜睫状体光凝术或小梁切除术的并发症。

结论

青光眼手术后 90 天内再次手术的早期并发症发生率较低,与既往研究相似。90 天内再次手术的常见指征包括伤口漏和管相关问题。

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