Departamento de Oftalmología, Hospital Universitario de Albacete, Albacete, Spain.
Departamento de Oftalmología, Hospital Universitario de Albacete, Albacete, Spain.
Arch Soc Esp Oftalmol (Engl Ed). 2021 Dec;96(12):631-639. doi: 10.1016/j.oftale.2020.12.004. Epub 2021 May 20.
To evaluate the efficacy and complication profile of excimer laser trabeculostomy (ELT), an emerging laser-based trabecular minimally invasive glaucoma surgery (MIGS), combined with cataract surgery in routine clinical practice.
Single-site, retrospective, interventional study. Preoperative and postoperative clinical data of patients with cataract and open-angle glaucoma (OAG) who underwent combined phacoemulsification and ELT were collected and analyzed at preoperative day, one week postoperatively, and after one, two, three, six, nine and 12 months. Main outcome measure was intraocular pressure (IOP). Qualified and complete success were defined as an IOP less than 21mmHg and an IOP reduction ≥20% from preoperative medicated IOP with or without adjuvant medical treatment, respectively.
Thirty-four eyes of 29 patients were included; 29 eyes completed 1-year follow-up. The mean preoperative IOP under medications was 20.9±2.6mmHg (±standard deviation, SD) and decreased significantly at one year (16.3±1.9; p<0.0001). The mean number of IOP-lowering medications decreased from 1.7±0.7 to 0.3±0.8 (p<0.0001) at the 12-month follow-up. At one year, 81% of eyes were medication free. Qualified and complete success was obtained in 62% and 58% of eyes, respectively. Two eyes had postoperative hyphema, three eyes had transient IOP spikes and one patient underwent a subsequent filtering surgery at three months.
Combining ELT with phacoemulsification in eyes with cataract and mild to moderate OAG significantly reduced IOP and medication use without meaningful complications after one-year follow-up in a real world clinical practice setting.
评估准分子激光小梁切开术(ELT)联合白内障手术的疗效和并发症,ELT 是一种新兴的基于激光的小梁微创青光眼手术(MIGS)。
单中心回顾性干预性研究。收集并分析了 29 例白内障合并开角型青光眼(OAG)患者行超声乳化白内障吸除术联合 ELT 术后 1 天、1 周、1、2、3、6、9 和 12 个月的临床资料。主要观察指标为眼压(IOP)。合格和完全成功定义为 IOP 低于 21mmHg,或与术前药物治疗相比,IOP 降低≥20%,且无需辅助药物治疗。
34 只眼(29 例患者)纳入研究,29 只眼完成 1 年随访。术前药物治疗的平均 IOP 为 20.9±2.6mmHg(±标准差,SD),术后 1 年显著降低(16.3±1.9mmHg;p<0.0001)。12 个月随访时,平均降眼压药物种类从 1.7±0.7 降至 0.3±0.8(p<0.0001)。术后 1 年,81%的患者无需药物治疗。62%的眼获得合格成功,58%的眼获得完全成功。2 只眼发生术后前房积血,3 只眼发生一过性眼压升高,1 例患者术后 3 个月行滤过性手术。
在伴有白内障和轻中度 OAG 的眼中,ELT 联合白内障超声乳化术可显著降低眼压和用药量,在真实世界临床实践中,术后 1 年无明显并发症。