23697Regional Medical Center Bayonet Point, Department of Transitional Year, Hudson, Florida, USA.
14742University of Texas Health Science Center San Antonio, 12345Long School of Medicine, San Antonio, Texas, USA.
Eur J Ophthalmol. 2022 Sep;32(5):2870-2879. doi: 10.1177/11206721211056585. Epub 2021 Nov 15.
Neodymium-doped yttrium aluminum garnet laser goniopuncture is an adjuvant procedure for nonpenetrating deep sclerectomy. We investigated optimal laser goniopuncture timing and the effect of laser iridoplasty on success rates.
This single-center retrospective cohort study compared intraocular pressure control in patients with early versus late laser goniopuncture after nonpenetrating deep sclerectomy and evaluated the effects of laser iridoplasty pretreatment. A 3-month cut-off was used to define early versus late laser goniopuncture. The primary outcome was the proportion of patients maintaining intraocular pressure control according to definitions of complete (no medications) and qualified (with medications) success at 15, 18, and 21 mmHg thresholds. Data were analyzed using right-censored Kaplan-Meier estimation and log-rank testing.
A total of 124 eyes of 124 patients were analyzed. Complete success rates after 3 years were 9.2%, 14.6%, and 23.3% for early laser goniopuncture and 21.8%, 26.0%, and 55.4% for late laser goniopuncture for 15, 18, and 21 mmHg, respectively (all < .01). Qualified success rates after 3 years were 16.6%, 24.8%, and 40.9% for early laser goniopuncture and 21.5%, 56.1%, and 69.6% for late laser goniopuncture for 15, 18, and 21 mmHg, respectively ( = .096, .0026, .0061). Late laser goniopuncture was associated with decreased risk of iris incarceration and bleb collapse. Iridoplasty pretreatment was not associated with improved outcomes.
Late laser goniopuncture (3-month cut-off) was associated with better intraocular pressure control and less adverse events than early laser goniopuncture.
掺钕钇铝石榴石激光房角切开术是一种辅助非穿透性深层巩膜切除术的方法。我们研究了最佳的激光房角切开术时机以及激光虹膜成形术对成功率的影响。
这项单中心回顾性队列研究比较了非穿透性深层巩膜切除术后早期与晚期激光房角切开术对眼压控制的影响，并评估了激光虹膜成形术预处理的效果。以 3 个月为界，将患者分为早期与晚期激光房角切开术。主要结局是根据完全（无需药物）和合格（需药物）成功的定义，在 15、18 和 21mmHg 阈值下，维持眼压控制的患者比例。使用右删失 Kaplan-Meier 估计和对数秩检验进行数据分析。
共分析了 124 例患者的 124 只眼。早期激光房角切开术的 3 年完全成功率分别为 15mmHg 时的 9.2%、18mmHg 时的 14.6%和 21mmHg 时的 23.3%，晚期激光房角切开术的 3 年完全成功率分别为 15mmHg 时的 21.8%、18mmHg 时的 26.0%和 21mmHg 时的 55.4%（均 < .01）。早期激光房角切开术的 3 年合格成功率分别为 15mmHg 时的 16.6%、18mmHg 时的 24.8%和 21mmHg 时的 40.9%，晚期激光房角切开术的 3 年合格成功率分别为 15mmHg 时的 21.5%、18mmHg 时的 56.1%和 21mmHg 时的 69.6%（ = .096， .0026， .0061）。晚期激光房角切开术与虹膜嵌顿和滤过泡塌陷风险降低相关。激光虹膜成形术预处理与改善结局无关。
与早期激光房角切开术相比，3 个月时的晚期激光房角切开术（时间界值）与更好的眼压控制和更少的不良事件相关。
