Mehta Rajvi, Tomatzu Shizuka, Cao Dingcai, Pleet Alexander, Mokhur Alexander, Aref Ahmad A, Vajaranant Thasarat Sutabutr
Illinois Eye and Ear Infirmary, 1855 W. Taylor Street, M/C 648, Chicago, IL, 60612, USA.
Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine, Chicago, IL, USA.
Ophthalmol Ther. 2022 Feb;11(1):311-320. doi: 10.1007/s40123-021-00434-2. Epub 2021 Dec 4.
To evaluate the refractive outcome of combined cataract extraction and glaucoma drainage device (GDD) surgery.
Patients who had undergone combined phacoemulsification with GDD surgery [Baerveldt, Abbott Medical, Abbott Park (IL) or Ahmed valve, New World Medical, Rancho Cucamonga (CA)] between June 2009 and August 2017 were included in the study. The main outcome measure evaluated was whether or not spherical equivalent (SE) between ± 1D from target refraction was achieved at 3-6 months postoperatively.
The final analysis included 42 eyes of 38 patients who underwent combined phacoemulsification and GDD surgery. A refractive outcome of spherical equivalent (SE) between ± 1D of the target refraction was achieved in 30 of 42 eyes (71.43%) at 3-6 months after surgery. Mean preoperative axial length (AL) of eyes with postoperative SE outside ± 1D from target (SD = 0.98, p = 0.003) was noted to be 25.37 ± 0.98 mm (longer mean AL) and that of eyes with SE between ± 1D (SD = 0.89, p = 0.000) was found to be 23.34 ± 0.89 mm (average mean AL). Twelve (29%) eyes were noted to have a mean 0.52D (SD = 0.49; range 0.02-1.49) of corneal astigmatism induced by combined surgery. Age, central corneal thickness, preoperative anterior chamber depth, and pre- and postoperative intraocular pressure did not significantly affect refractive outcomes.
Refractive outcomes within 1.00D of the target refraction were achieved in most patients undergoing a combined surgical approach. Longer AL was a risk factor among patients with refractive change > 1.00D from target.
评估白内障摘除联合青光眼引流装置（GDD）手术的屈光效果。
纳入2009年6月至2017年8月期间接受白内障超声乳化联合GDD手术（Baerveldt，雅培医疗，雅培公园（伊利诺伊州）或艾哈迈德瓣膜，新世界医疗，兰乔库卡蒙加（加利福尼亚州））的患者。评估的主要结局指标是术后3至6个月时是否达到目标屈光度数±1D之间的等效球镜度（SE）。
最终分析纳入了38例接受白内障超声乳化联合GDD手术患者的42只眼。术后3至6个月时，42只眼中有30只（71.43%）达到了目标屈光度数±1D之间的屈光效果。术后SE超出目标度数±1D的眼术前平均眼轴长度（AL）（标准差=0.98，p=0.003）为25.37±0.98mm（平均AL较长），而SE在±1D之间的眼术前平均眼轴长度（标准差=0.89，p=0.000）为23.34±0.89mm（平均AL为平均值）。联合手术导致12只（29%）眼平均有0.52D（标准差=0.49；范围0.02-1.49）的角膜散光。年龄、中央角膜厚度、术前前房深度以及术前和术后眼压对屈光效果没有显著影响。
大多数接受联合手术的患者屈光效果在目标屈光度数1.00D以内。眼轴较长是屈光变化超出目标度数>1.00D的患者的一个危险因素。
