Mori Sotaro, Murai Yusuke, Ueda Kaori, Sakamoto Mari, Kurimoto Takuji, Yamada-Nakanishi Yuko, Nakamura Makoto
Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan.
BMJ Open Ophthalmol. 2020 Mar 5;5(1):e000446. doi: 10.1136/bmjophth-2020-000446. eCollection 2020.
To compare the 1-year outcomes of trabeculotomy ( TLO) and trabeculotomy using a microhook ( TLO) for glaucoma patients using propensity score analysis.
The medical charts of 65 consecutive patients who underwent TLO and those of 69 patients who underwent TLO were reviewed. Logistic regression analysis was conducted to calculate the propensity score using 1:1 matched analysis, which indicates the likelihood of surgical success at 12 months. We set the outcome-related covariates as age, glaucoma type, mean deviation, preoperative intraocular pressure (IOP), the number of preoperative glaucoma eye drops and the presence or absence of combined cataract surgery. Fifty eyes per each surgery group were subsequently compared.
The mean preoperative IOP was 32.5±11.2 mm Hg in the TLO group and 28.4±7.8 mm Hg in the TLO group (p=0.08). The mean postoperative IOP at 12 months was 18.3±7.4 mm Hg in the former group and 17.8±6.3 mm Hg in the latter (p=0.91). When surgical success was defined as a postoperative IOP of between 5 and 21 mm Hg with a more than 20% IOP reduction from baseline and no additional glaucoma surgery, the rate at 12 months was 78% in the TLO group and 74% in the TLO group (p=1.00).
The 1-year success rate was not significantly different between and TLO.
采用倾向评分分析比较小梁切开术（TLO）和使用微钩的小梁切开术治疗青光眼患者的1年疗效。
回顾了65例连续接受小梁切开术患者和69例接受使用微钩小梁切开术患者的病历。采用1:1匹配分析进行逻辑回归分析以计算倾向评分，该评分表明12个月时手术成功的可能性。我们将与结局相关的协变量设定为年龄、青光眼类型、平均偏差、术前眼压（IOP）、术前青光眼滴眼液使用次数以及是否合并白内障手术。随后对每个手术组的50只眼进行了比较。
小梁切开术组术前平均眼压为32.5±11.2 mmHg，使用微钩小梁切开术组为28.4±7.8 mmHg（p = 0.08）。前一组12个月时术后平均眼压为18.3±7.4 mmHg，后一组为17.8±6.3 mmHg（p = 0.91）。当手术成功定义为术后眼压在5至21 mmHg之间，眼压较基线降低超过20%且无需额外的青光眼手术时，小梁切开术组12个月时的成功率为78%，使用微钩小梁切开术组为74%（p = 1.00）。
小梁切开术和使用微钩小梁切开术的1年成功率无显著差异。
