Department of Ophthalmology, National Healthcare Group Eye Institute, Khoo Teck Puat Hospital, Yishun, Singapore.
Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore.
Int Ophthalmol. 2021 Apr;41(4):1445-1454. doi: 10.1007/s10792-021-01707-2. Epub 2021 Jan 22.
To evaluate and compare outcomes of CO laser-assisted sclerectomy surgery (CLASS) with mitomycin C (MMC) combined with or without phacoemulsification in adult Asian glaucoma patients.
Retrospective, comparative study.
Adult Asian glaucoma patients who underwent CLASS alone or combined with phacoemulsification using standardized surgery by two trained glaucoma surgeons between 2014 and 2016 were identified. The main measures of outcome were: intraocular pressure (IOP), use of supplemental medical therapy, best-corrected visual acuity (BCVA), microperforations, macroperforations, and repeated intervention(s) for glaucoma.
Forty-one eyes who underwent CLASS alone (13 eyes) or combined with phacoemulsification (28 eyes) were included. Overall, BCVA improved from 0.28 ± 0.19 to 0.14 ± 0.17, and 0.17 ± 0.19, 0.22 ± 0.24, and 0.18 ± 0.23 at 6, 12, 24, and 36 months, respectively. Mean IOP dropped from 17.9 ± 4.7 mmHg to 14.6 ± 5.5, 13.9 ± 3.3, 14.3 ± 3.6, and 14.1 ± 3.7 mmHg, and average number of medications reduced from 2.9 ± 0.9 to 0.2 ± 0.6, 0.5 ± 0.9, 1.0 ± 1.2, and 1.3 ± 1.4 at the same time points. There was no statistically significant difference in BCVA, IOP, and medication reduction between the two groups.
CLASS combined with or without phacoemulsification was equally safe and effective, but yielded more modest results in our population.
评估和比较 CO2 激光辅助巩膜切除术（CLASS）联合或不联合超声乳化术与丝裂霉素 C（MMC）治疗亚洲成年青光眼患者的疗效。
回顾性、对比研究。
回顾性分析了 2014 年至 2016 年间由两位训练有素的青光眼医生采用标准化手术方法行单纯 CLASS 手术或 CLASS 联合超声乳化术治疗的成年亚洲青光眼患者。主要观察指标为：眼压（IOP）、辅助药物治疗、最佳矫正视力（BCVA）、微穿孔、大穿孔和青光眼的重复干预。
共纳入 41 例（CLASS 组 13 例，联合超声乳化术组 28 例）患者。总的来说，BCVA 从 0.28±0.19 提高到 0.14±0.17、0.22±0.24 和 0.18±0.23，分别在术后 6、12、24 和 36 个月；平均 IOP 从 17.9±4.7mmHg 下降到 14.6±5.5、13.9±3.3、14.3±3.6 和 14.1±3.7mmHg，药物平均使用数量从 2.9±0.9 减少到 0.2±0.6、0.5±0.9、1.0±1.2 和 1.3±1.4。两组间 BCVA、IOP 和药物减少量的差异无统计学意义。
CLASS 联合或不联合超声乳化术均安全有效，但在本研究人群中效果更温和。
