Centro de Ojos Quilmes, afiliado a la Universidad de Buenos Aires, Buenos Aires, Argentina.
Centro de Ojos Quilmes, afiliado a la Universidad de Buenos Aires, Buenos Aires, Argentina.
Arch Soc Esp Oftalmol (Engl Ed). 2020 Jul;95(7):327-333. doi: 10.1016/j.oftal.2020.03.002. Epub 2020 May 12.
To determine the effectiveness and safety of the micropulse transscleral technique in lowering intraocular pressure in patients with glaucoma.
A retrospective cohort study was conducted on 143 eyes with various glaucoma subtypes between October 2016 and December 2018. Patients were grouped for analysis based on glaucoma subtypes, preoperative demographics, previous surgical procedures, and postoperative results. The data collected was based on intra- and post-operative complications, intraocular pressure, visual acuity, the need of micropulse re-treatment, incisional glaucoma surgery, and increasing the dose/quantity of medications. A logistic and Cox regression model was performed to determine predictors of therapeutic failure, in addition to building Kaplan-Meier curves.
The mean follow-up was 268 days, and 63% of the patients completed one year. The micropulse procedure achieved a mean intraocular pressure decline of 7.3mmHg (excluding neovascular glaucoma), independent of the glaucoma subtype. The percentage of patients who achieved intraocular pressure less than 20mmHg at 24h was 78%, with 80% at 3 months, 77% at 6 months, and 78% at 12 months. During the follow-up, 29.6% of the patients required additional treatment or a dose increase. Only 2patients presented with minimal postoperative complications.
The treatment with transscleral micropulse is a safe and efficient technique for use in glaucoma, attaining a reduction in intraocular pressure and decrease in need of antihypertensive medications within the first year following the procedure.
确定微脉冲经巩膜技术降低青光眼患者眼压的有效性和安全性。
对 2016 年 10 月至 2018 年 12 月期间的 143 只不同青光眼亚型的眼睛进行了回顾性队列研究。根据青光眼亚型、术前人口统计学、先前手术程序和术后结果对患者进行分组分析。收集的数据基于术中及术后并发症、眼压、视力、微脉冲再治疗的需要、切口性青光眼手术以及增加药物剂量/数量。进行逻辑回归和 Cox 回归模型以确定治疗失败的预测因素，并建立 Kaplan-Meier 曲线。
平均随访时间为 268 天，63%的患者完成了一年的随访。微脉冲程序使眼压平均降低 7.3mmHg（不包括新生血管性青光眼），与青光眼亚型无关。24 小时内眼压低于 20mmHg 的患者百分比为 78%，3 个月时为 80%，6 个月时为 77%，12 个月时为 78%。在随访期间，29.6%的患者需要额外的治疗或剂量增加。仅 2 例患者出现轻微的术后并发症。
经巩膜微脉冲治疗是一种安全有效的青光眼治疗方法，可在术后第一年降低眼压并减少抗高血压药物的需求。
