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日本青光眼专家对青光眼手术的临床实践偏好:一项日本青光眼学会专家调查。

Clinical practice preferences for glaucoma surgery in Japan: a survey of Japan Glaucoma Society specialists.

机构信息

Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji, Yoshida, Fukui, 910-1193, Japan.

出版信息

Jpn J Ophthalmol. 2020 Jul;64(4):385-391. doi: 10.1007/s10384-020-00749-w. Epub 2020 May 30.

Abstract

PURPOSE

This study evaluated the surgical practice patterns of glaucoma management followed by glaucoma specialists in Japan.

METHODS

A survey was administered to 50 glaucoma specialists who were councilors in the Japan Glaucoma Society about surgical preferences and postoperative glaucoma care.

RESULTS

All 50 glaucoma specialists participated in the survey. Results show that, in 2019, compared to conventional trabeculotomy (4.6%), the frequency of minimally invasive glaucoma surgery (MIGS), combined with phacoemulsification, remarkably increased (79.0%) for non-operated eyes with mild open-angle glaucoma associated with cataract. Tube-shunt surgery was performed more often for open-angle glaucoma with previously twice failed trabeculectomy (65.8%) and neovascular glaucoma with previously once failed trabeculectomy (63.4%). In addition, during one year post-operatively, MIGS required less frequent follow-up visits compared to filtering surgery.

CONCLUSION

Although glaucoma specialists in the Japan Glaucoma Society usually prefer trabeculectomy, in the past decade they have selected tube-shunt surgery more often to treat refractory glaucoma. MIGS is increasing remarkably as the choice primary glaucoma surgery.

摘要

目的

本研究评估了日本青光眼专家在青光眼治疗方面的手术实践模式。

方法

向日本青光眼学会的 50 名顾问青光眼专家发放了一份关于手术偏好和术后青光眼护理的调查问卷。

结果

所有 50 名青光眼专家均参与了调查。结果显示,与传统小梁切开术(4.6%)相比,2019 年,对于伴有白内障的轻度开角型青光眼非手术眼,微创青光眼手术(MIGS)联合超声乳化术的应用频率显著增加(79.0%)。对于曾两次小梁切除术失败的开角型青光眼(65.8%)和曾一次小梁切除术失败的新生血管性青光眼(63.4%),更常施行引流管手术。此外,与滤过性手术相比,MIGS 在术后一年需要更频繁的随访。

结论

尽管日本青光眼学会的青光眼专家通常倾向于小梁切除术,但在过去十年中,他们更常选择引流管手术来治疗难治性青光眼。MIGS 作为原发性青光眼手术的选择显著增加。

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