Xin ZhiYuan, Chen Jeremy, Wang DaJiang, Wu Xing, Han Ying
Department of Ophthalmology, The Third Medical Center of Chinese PLA General Hospital, Beijing, China.
Department of Ophthalmology, 8785University of California San Francisco, San Francisco, CA, USA.
Eur J Ophthalmol. 2022 Jan 12:11206721211073035. doi: 10.1177/11206721211073035.
To evaluate the efficacy and safety of CO-Laser Assisted Sclerectomy Surgery (CLASS) with 5-fluorouracil (5-FU) in treating open-angle glaucoma (OAG) in Chinese patients. This was a retrospective, uncontrolled, interventional case series. All patients from 2016 to 2017 who received CLASS were recruited in this study. The primary outcome was the change in intraocular pressure (IOP) and the number of IOP-lowering medications over a 12-month follow-up period. Adverse events were evaluated as secondary outcomes. Data were collected from forty-two eyes of 31 patients. The average preoperative IOP was 31.33 ± 7.60mmHg. The mean percentage of IOP reduction from baseline at postoperative months (POM) 1, 3, 6, 9, and, 12 were 48.1% ± 24.6%, 51.4% ± 19.3%, 51.2% ± 17.2%, 50.9% ± 15.0%, 49.2% ± 16.3%, respectively (all < 0.001). The number of glaucoma medications decreased from a baseline of 3.02 ± 0.81 to 0.05 ± 0.22, 0.10 ± 0.37, 0.12 ± 0.40, 0.17 ± 0.44, and 0.24 ± 0.58 at POM 1, 3, 6, 9, and 12, respectively (all < 0.001). At POM 1, 3, 6, 9, and 12, complete success rates were 66.7%, 73.8%, 76.2%, 69.1%, and 71.4%, respectively. At POM 1, 3, 6, 9, and 12, qualified success rates were 71.4%, 82.0%, 85.3%, 83.3%, and 90.5%, respectively. Major postoperative complications include peripheral iris synechia, iris incarceration, and anterior chamber shallowing. CLASS with 5-FU shows safety and efficacy for decreasing IOP and the number of IOP-lowering medications over a 12-month follow-up period. It could be an alternative treatment for patients with OAG.
评估二氧化碳激光辅助巩膜切除术(CLASS)联合5-氟尿嘧啶(5-FU)治疗中国患者开角型青光眼(OAG)的疗效和安全性。这是一项回顾性、非对照、干预性病例系列研究。纳入了2016年至2017年所有接受CLASS治疗的患者。主要结局是12个月随访期内眼压(IOP)的变化以及降眼压药物的数量。不良事件作为次要结局进行评估。收集了31例患者42只眼的数据。术前平均眼压为31.33±7.60mmHg。术后第1、3、6、9和12个月时,眼压较基线降低的平均百分比分别为48.1%±24.6%、51.4%±19.3%、51.2%±17.2%、50.9%±15.0%、49.2%±16.3%(均P<0.001)。青光眼药物数量从基线的3.02±0.81分别降至术后第1、3、6、9和12个月时的0.05±0.22、0.10±0.37、0.12±0.40、0.17±0.44和0.24±0.58(均P<0.001)。术后第1、3、6、9和12个月时,完全成功率分别为66.7%、73.8%、76.2%、69.1%和71.4%。术后第1、3、6、9和12个月时,合格成功率分别为71.4%、82.0%、85.3%、83.3%和90.5%。主要术后并发症包括周边虹膜粘连、虹膜嵌顿和前房变浅。CLASS联合5-FU在12个月随访期内显示出降低眼压和减少降眼压药物数量的安全性和有效性。它可能是OAG患者的一种替代治疗方法。