Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.
Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan.
Adv Ther. 2021 Jan;38(1):329-336. doi: 10.1007/s12325-020-01543-3. Epub 2020 Oct 28.
To study surgical outcomes of patients with a minimum of 6 months of follow-up after undergoing combined phacoemulsification with either microhook ab interno trabeculotomy (μLOT-Phaco) or goniotomy using the Kahook Dual Blade (KDB-Phaco).
This retrospective comparative case series examined 22 μLOT-Phaco eyes and 81 KDB-Phaco eyes that underwent surgery between December 2016 and October 2018. Data collected from medical records included pre- and postoperative intraocular pressure (IOP), number of IOP-lowering medications and complication occurrence. Potential risk factors for failure were determined by Cox proportional hazards regression analysis. Surgical failure was defined as an IOP of > 20 mmHg, < 20% reduction in preoperative IOP or additional glaucoma surgery. Kaplan-Meier survival analysis was used to assess success rates. Score matching used a genetic algorithm consisting of type of glaucoma.
Of 81 KDB-Phaco eyes, 22 eyes were matched to 22 μLOT-Phaco eyes. Mean IOP in the μLOT-Phaco group decreased from 24.7 ± 6.4 mmHg at baseline to 14.4 ± 3.0 mmHg (P < 0.01) and 13.0 ± 2.5 mmHg (P < 0.01) at 6 and 12 months, respectively. Mean IOP in the KDB-Phaco group decreased from 23.2 ± 5.4 mmHg to 15.8 ± 3.3 mmHg (P < 0.001) and 16.7 ± 2.1 mmHg (P < 0.001), respectively. Mean number of preoperative IOP-lowering medications in the μLOT-Phaco group at baseline was 3.7 ± 1.0, which decreased to 1.4 ± 1.5 (P < 0.01) at 12 months, while in the KDB-Phaco group it decreased from a baseline value of 3.3 ± 1.2 to 1.1 ± 1.4 (P < 0.01). Probability of qualified success at 12 months in the μLOT-Phaco and KDB-Phaco groups was 71.8% and 62.2%, respectively (P = 0.75). Similar postoperative complications were found between the groups.
Use of μLOT-Phaco and KDB-Phaco resulted in comparable IOPs and reductions in the number of medications.
研究接受超声乳化白内障吸除术联合微钩内路小梁切开术（μLOT-Phaco）或使用 Kahook 双刀片（KDB-Phaco）行房角切开术后至少随访 6 个月的患者的手术结果。
本回顾性病例对照系列研究纳入了 2016 年 12 月至 2018 年 10 月期间接受手术的 22 只 μLOT-Phaco 眼和 81 只 KDB-Phaco 眼。从病历中收集的资料包括术前和术后的眼压（IOP）、降眼压药物的数量和并发症发生情况。采用 Cox 比例风险回归分析确定手术失败的潜在危险因素。手术失败定义为眼压>20mmHg、IOP 降低<术前 20%或需要行额外的青光眼手术。Kaplan-Meier 生存分析用于评估成功率。评分匹配使用基于青光眼类型的遗传算法。
在 81 只 KDB-Phaco 眼中，有 22 只眼与 22 只 μLOT-Phaco 眼相匹配。μLOT-Phaco 组的平均眼压从基线时的 24.7±6.4mmHg 降至 6 个月时的 14.4±3.0mmHg（P<0.01）和 12 个月时的 13.0±2.5mmHg（P<0.01）。KDB-Phaco 组的平均眼压从 23.2±5.4mmHg 降至 6 个月时的 15.8±3.3mmHg（P<0.001）和 12 个月时的 16.7±2.1mmHg（P<0.001）。μLOT-Phaco 组基线时平均使用 3.7±1.0 种降眼压药物，在 12 个月时降至 1.4±1.5（P<0.01），而 KDB-Phaco 组从基线时的 3.3±1.2 种降至 1.1±1.4（P<0.01）。μLOT-Phaco 和 KDB-Phaco 组在 12 个月时的合格成功率分别为 71.8%和 62.2%（P=0.75）。两组的术后并发症相似。
使用 μLOT-Phaco 和 KDB-Phaco 可获得相似的眼压和药物使用数量减少。
