Dawson Emily F, Rosenberg Nicole C, Meyer Alissa M, Culpepper Brady E, Bolch Charlotte A, Wilson Mary K, Nguyen Phuong T, Rodgers Cooper D, Smith Ryan J, Blake Charles R, Sherwood Mark B
Department of Ophthalmology, University of Florida, Gainesville, FL.
The Edward Via College of Osteopathic Medicine, Spartanburg, SC.
J Glaucoma. 2021 Jul 1;30(7):585-595. doi: 10.1097/IJG.0000000000001852.
A comparison of 186 glaucoma patients with mixed diagnoses who underwent nonvalved glaucoma drainage device (GDD) implant surgery showed similar long-term intraocular pressure (IOP), medication, and visual acuity (VA) outcomes between those with prior failed trabeculectomy surgery versus those without.
The purpose of this study was to evaluate whether prior failed trabeculectomy adversely affects the outcome of glaucoma tube surgery.
A total of 186 eyes of 186 patients who underwent a nonvalved GDD implant surgery by a single surgeon between 1996 and 2015 at a University practice were included. Patients were of mixed diagnoses and over 18 years old. Before the GDD surgery, 65 had a previous failed glaucoma filtering surgery and 121 had no prior glaucoma surgery. Demographic information, preoperative and postoperative IOP, medication, VA, and complications were collected from chart review.
No significant difference was noted in mean IOP and mean medication use (13.0 and 12.6 mm Hg on 2.0 and 1.7 medication classes at 5 y postoperatively, respectively), mean VA and change in VA from baseline, or numbers of complications (P>0.05), between eyes that had a prior failed filtration surgery and those that had not. Kaplan-Meier plots for failure over 5 years using a lower limit of <5 mm Hg and an upper limit of ≥18, ≥15, or ≥12 mm Hg did not show a significant difference between groups. Subanalyses were performed to examine only primary glaucoma eyes and results were similar. Further group subanalyses comparing those with baseline IOP ≥25 or <25 mm Hg, age 65 and above or below 65 years and those specifically with Baerveldt 350 mm2 implants also did not show significant differences.
Prior failed filtration surgery does not appear to affect the outcome of future GDD surgery.
对186例接受非阀门式青光眼引流装置（GDD）植入手术的混合型青光眼患者进行比较，结果显示，既往小梁切除术失败的患者与未接受过该手术的患者在长期眼压（IOP）、用药及视力（VA）方面的结果相似。
本研究旨在评估既往小梁切除术失败是否会对青光眼引流管手术的结果产生不利影响。
纳入1996年至2015年间在某大学医疗机构由同一位外科医生进行非阀门式GDD植入手术的186例患者的186只眼。患者诊断混合型，年龄超过18岁。在GDD手术前，65例患者既往青光眼滤过手术失败，121例患者既往未接受过青光眼手术。通过查阅病历收集人口统计学信息、术前和术后眼压、用药、视力及并发症情况。
既往滤过手术失败的眼与未失败的眼在术后5年的平均眼压和平均用药量（分别为13.0和12.6 mmHg，使用2.0和1.7种药物类别）、平均视力及视力较基线的变化，或并发症数量方面均未发现显著差异（P>0.05）。使用下限<5 mmHg和上限≥18、≥15或≥12 mmHg绘制的5年失败率的Kaplan-Meier曲线在两组之间未显示出显著差异。进行亚组分析仅检查原发性青光眼眼，结果相似。进一步的分组亚组分析比较基线眼压≥25或<25 mmHg、年龄65岁及以上或以下，以及专门使用Baerveldt 350 mm2植入物的患者，也未显示出显著差异。
既往滤过手术失败似乎不影响未来GDD手术的结果。
