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小梁切开术(FTO)与传统小梁切除术(TE)对比的结果——一项配对病例对照研究

[Results of filtering trabeculotomy (FTO) compared to conventional trabeculectomy (TE)-a matched case control study].

作者信息

Glatzel Caroline Maria, Patzkó Ágnes, Matlach Juliane, Grehn Franz

机构信息

Universitätsklinik für Dermatologie und Venerologie, Josef Schneider Str. 11, 97080, Würzburg, Deutschland.

Universitäts-Augenklinik Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Deutschland.

出版信息

Ophthalmologe. 2021 May;118(5):461-469. doi: 10.1007/s00347-021-01365-w. Epub 2021 Mar 29.

DOI:10.1007/s00347-021-01365-w
PMID:33779826
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8105228/
Abstract

OBJECTIVE

The aim of this study was to examine the 2‑year results of filtering trabeculotomy (FTO) compared to conventional trabeculectomy (TE) in primary open-angle glaucoma, pseudoexfoliation glaucoma, and pigmentary glaucoma.

PATIENTS AND METHODS

Thirty consecutive patients after FTO and 87 patients after TE were included in the study. Both groups were matched 1:3 according to age and intraocular pressure (IOP). The primary endpoint was reaching the target IOP after 2 years. An IOP without medication of ≤ 18 mm Hg and an IOP reduction of ≥ 30% were defined as complete success, and as qualified success with medication. Secondary endpoints were mean IOP reduction, resulting visual acuity, complications and subsequent operations. The surgical technique of the FTO is available as a video for this article.

RESULTS

The 2‑year data from 27 patients with FTO and 68 patients with TE were evaluated. The patients in both groups were matched according to age and IOP but were also homogeneous with respect to visual acuity, gender, and medication. The preoperative IOP with glaucoma medication was 23.0 mm Hg in both groups. According to the defined criteria, a qualified 2‑year success was achieved in 70.4% of the FTO group and in 77.6% of the TE group (p = 0.60) and a complete 2‑year success in 33.3% of the FTO group and 56.7% of the TE group (p = 0.07). The IOP was significantly reduced after 24 months in both surgical groups (p < 0.001) and was 12.8 mm Hg in the FTO group and 11.0 mm Hg in the TE group. Visual acuity was moderately reduced postoperatively but did not differ significantly between the two groups. Complication and reoperation rates were low and not different between both groups.

CONCLUSION

The results of FTO and TE are largely similar after 2 years in terms of complete and qualified success rate, lowering of IOP, visual acuity, and complications.

摘要

目的

本研究旨在比较小梁切开滤过术(FTO)与传统小梁切除术(TE)治疗原发性开角型青光眼、剥脱性青光眼和色素性青光眼的2年疗效。

患者与方法

本研究纳入了30例接受FTO治疗的连续患者和87例接受TE治疗的患者。两组根据年龄和眼压(IOP)按1:3进行匹配。主要终点是2年后达到目标眼压。眼压≤18 mmHg且无需药物治疗,眼压降低≥30%被定义为完全成功,使用药物治疗后眼压降低被定义为合格成功。次要终点包括平均眼压降低、最终视力、并发症及后续手术情况。本文提供了FTO手术技术的视频。

结果

对27例接受FTO治疗的患者和68例接受TE治疗的患者的2年数据进行了评估。两组患者在年龄和眼压方面相匹配,在视力、性别和用药情况方面也具有同质性。两组患者术前使用青光眼药物治疗时的眼压均为23.0 mmHg。根据既定标准,FTO组2年合格成功率为70.4%,TE组为77.6%(p = 0.60);FTO组2年完全成功率为33.3%,TE组为56.7%(p = 0.07)。术后24个月,两组手术患者的眼压均显著降低(p < 0.001),FTO组眼压为12.8 mmHg,TE组眼压为11.0 mmHg。术后视力有中度下降,但两组间无显著差异。并发症和再次手术率较低,两组间无差异。

结论

在完全成功率和合格成功率、眼压降低、视力及并发症方面,FTO和TE术后2年的结果大致相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88cb/8105228/80b21b858adc/347_2021_1365_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88cb/8105228/9134174ff51e/347_2021_1365_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88cb/8105228/c5480ad4e994/347_2021_1365_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88cb/8105228/61442bb81886/347_2021_1365_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88cb/8105228/80b21b858adc/347_2021_1365_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88cb/8105228/9134174ff51e/347_2021_1365_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88cb/8105228/c5480ad4e994/347_2021_1365_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88cb/8105228/61442bb81886/347_2021_1365_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88cb/8105228/80b21b858adc/347_2021_1365_Fig4_HTML.jpg

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Ab externo implantation of the MicroShunt, a poly (styrene--isobutylene--styrene) surgical device for the treatment of primary open-angle glaucoma: a review.用于治疗原发性开角型青光眼的聚(苯乙烯-异丁烯-苯乙烯)手术装置MicroShunt的外部植入:综述
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Treatment Outcomes in the Primary Tube Versus Trabeculectomy Study after 3 Years of Follow-up.
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