Esfandiari Hamed, Prager Alisa, Hassanpour Kiana, Kurup Sudhi P, Mets-Halgrimson Rebecca, Yoon Hawke, Zeid Janice Lasky, Mets Marilyn B, Rahmani Bahram
Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA.
Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, USA.
J Ophthalmic Vis Res. 2020 Aug 6;15(3):326-330. doi: 10.18502/jovr.v15i3.7451. eCollection 2020 Jul-Sep.
To evaluate the long-term visual outcomes of ab externo trabeculotomy for primary congenital glaucoma (PCG) at a single pediatric ophthalmology center.
In this retrospective single-center case series, data from 63 eyes of 40 patients who underwent ab externo trabeculotomy between September 2006 and June 2018 were included. The data were analyzed for best corrected visual acuity (BCVA), stereopsis, and surgical success. Kaplan-Meier analysis was performed using the surgical success criteria defined as intraocular pressure (IOP) 21 mmHg and 20% below baseline without the need for additional glaucoma surgery.
BCVA at the time of diagnosis was 0.37 0.48 logMAR, which changed to 0.51 0.56 logMAR at the final follow-up ( = 0.08). Twenty-five percent of patients had BCVA equal to or better than 20/40 at the final visit. The mean refraction at baseline was -4.78 5.87 diopters, which changed to less myopic refraction of -2.90 3.83 diopters at the final visit. Optical correction was prescribed in 66% of eyes at the final visit. The average final stereopsis was 395.33 sec of arc. The linear regression model showed a significant association between the surgery success rate and final BCVA as well as stereoacuity (-values: 0.04 and 0.03, respectively). Intraocular pressure (IOP) decreased significantly from 29.79 7.67 mmHg at baseline to 16.13 3.41 mmHg at the final follow-up ( = 0.001).
Patients with PCG can achieve an acceptable visual acuity and stereoacuity, particularly in cases of timely intervention and close follow-up.
在单一小儿眼科中心评估外路小梁切开术治疗原发性先天性青光眼（PCG）的长期视觉效果。
在这个回顾性单中心病例系列中，纳入了2006年9月至2018年6月期间接受外路小梁切开术的40例患者的63只眼的数据。分析数据以评估最佳矫正视力（BCVA）、立体视和手术成功率。采用手术成功标准进行Kaplan-Meier分析，手术成功标准定义为眼压（IOP）≤21 mmHg且比基线降低≥20%，无需额外的青光眼手术。
诊断时的BCVA为0.37±0.48 logMAR，在最后一次随访时变为0.51±0.56 logMAR（P = 0.08）。25%的患者在最后一次就诊时BCVA等于或优于20/40。基线时的平均屈光度为-4.78±5.87屈光度，在最后一次就诊时变为近视度数较低的-2.90±3.83屈光度。在最后一次就诊时，66%的眼睛需要进行光学矫正。最终平均立体视锐度为395.33角秒。线性回归模型显示手术成功率与最终BCVA以及立体视锐度之间存在显著关联（P值分别为0.04和0.03）。眼压（IOP）从基线时的29.79±7.67 mmHg显著降低至最后一次随访时的16.13±3.41 mmHg（P = 0.001）。
PCG患者可以获得可接受的视力和立体视锐度，尤其是在及时干预和密切随访的情况下。
