Department of Ophthalmology, University of Florida, Gainesville, FL, US.
Asia Pac J Ophthalmol (Phila). 2021 Nov 24;10(6):553-563. doi: 10.1097/APO.0000000000000452.
To report outcomes of glaucoma drainage device (GDD) surgery based on primary or secondary glaucoma diagnosis and lens status.
Single-center, retrospective, consecutive cohort study.
University of Florida patients aged 18 to 93 years who underwent nonvalved GDD surgery between 1996 and 2015 with a minimum of 1-year follow-up were examined. Of the 186 eyes of 186 patients enrolled, 108 had a primary glaucoma and 78 a secondary glaucoma diagnosis. Excluding 13 aphakic patients, 57 eyes were phakic and 116 pseudophakic. Mean intraocular pressure (IOP), mean number of medications, visual acuity (VA), surgical complications, and failure (IOP ≥18 mm Hg, IOP <6 mm Hg, reoperation for glaucoma, or loss of light perception) were the main outcome measures.
No significant difference was noted in mean IOP and mean medication use (12.8 ± 4.5 and 13.0 ± 6.6 mm Hg on 2.0 ± 1.2 and 1.5 ± 1.1 medication classes, respectively), mean VA (1.08 ± 0.98 and 0.94 ± 0.89, respectively), failure, or numbers of complications and reoperations (P > 0.05) between eyes with primary and secondary glaucomas at up to 5 years postoperatively. Comparison of phakic and pseudophakic eyes showed a statistically significant higher success rate for the pseudophakic patient group at the ≥18 mm Hg upper limit and <6 mm Hg lower limit (P = 0.01), and significantly fewer eyes required reoperation to lower IOP (6.9% vs 23%).
GDD surgery appears equally effective for secondary glaucomas as for primary glaucomas, and has a better outcome for pseudophakic eyes than phakic eyes.
根据原发性或继发性青光眼诊断和晶状体状态报告青光眼引流装置（GDD）手术的结果。
单中心回顾性连续队列研究。
对 1996 年至 2015 年间在佛罗里达大学接受非瓣膜 GDD 手术且随访时间至少 1 年的 186 例 186 名患者的 186 只眼进行了检查。在纳入的 186 例患者的 108 例原发性青光眼和 78 例继发性青光眼中，排除 13 例无晶状体眼患者后，57 只眼为有晶状体眼，116 只为人工晶状体眼。主要观察指标为眼内压（IOP）均值、药物使用数量均值、视力（VA）、手术并发症和失败情况（IOP≥18mmHg、IOP＜6mmHg、再次手术治疗青光眼或光感丧失）。
在术后 5 年内，原发性和继发性青光眼患者的 IOP 均值和药物使用数量均值（分别为 12.8±4.5mmHg 和 13.0±6.6mmHg，使用 2.0±1.2 类和 1.5±1.1 类药物）、VA 均值（分别为 1.08±0.98 和 0.94±0.89）、失败率或并发症和再次手术数量（P＞0.05）无显著差异。有晶状体眼和人工晶状体眼的比较显示，人工晶状体眼组在 IOP 高于 18mmHg 的上限和低于 6mmHg 的下限方面成功率更高（P=0.01），需要进一步降低眼压的手术数量更少（6.9%比 23%）。
GDD 手术治疗继发性青光眼与原发性青光眼同样有效，并且对人工晶状体眼的效果优于有晶状体眼。
