Nakakura Shunsuke, Asaoka Ryo
Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan.
Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.
Eye Vis (Lond). 2022 Mar 1;9(1):9. doi: 10.1186/s40662-022-00279-1.
To evaluate the postoperative outcomes of initial trabeculectomy (Trab) and Ex-PRESS (EX) in terms of achieving an intraocular pressure (IOP) below 15 and 18 mmHg.
This study retrospectively analyzed 64 and 54 cases of Trab and EX, respectively, performed by the same surgeon with uniform management from April 2018 to March 2019. Surgical success was defined as 5 < IOP < 15 mmHg (criterion 1) and 5 < IOP < 18 mmHg (criterion 2) without additional glaucoma medication, needling, and bleb reconstruction 2 months after surgery. Survival analysis with Cox regression was performed to identify factors associated with postoperative outcomes.
The Trab and EX groups had an IOP of 22.6 ± 6.2 vs. 21.8 ± 6.0 mmHg before surgery (P = 0.507), 12.6 ± 2.6 vs. 14.0 ± 4.4 mmHg (P = 0.06) at 6 months, 12.7 ± 2.3 vs. 12.9 ± 2.8 mmHg (P = 0.678) at 12 months, 13.3 ± 2.6 vs. 12.6 ± 2.8 mmHg (P = 0.260) at 18 months, and 13.2 ± 2.3 vs. 13.6 ± 2.8 mmHg (P = 0.444) at 24 months, respectively. The proportion of those with an IOP < 15 mmHg in the Trab and EX groups was 82% vs. 81% at 6 months, 68% vs. 62% at 12 months, 63% vs. 61% at 18 months, and 57% vs. 53% at 24 months, respectively. The log-rank test showed no significant difference between the groups for Criteria 1 (P = 0.755) and 2 (P = 0.138). The results of the multivariate logistic analysis identified only a high preoperative IOP as a risk factor for surgical failure (odds ratio for Criteria 1: 1.076, P = 0.009 and Criteria 2: 1.068, P = 0.048).
Postoperative outcomes of Trab and EX suggested similar ability for achieving an IOP below 15 and 18 mmHg without medications and interventions.
评估初次小梁切除术（Trab）和Ex-PRESS植入术（EX）在使眼压低于15 mmHg和18 mmHg方面的术后效果。
本研究回顾性分析了2018年4月至2019年3月由同一位外科医生进行的、管理统一的64例Trab手术和54例EX手术。手术成功定义为术后2个月时眼压在5 mmHg <眼压< 15 mmHg（标准1）和5 mmHg <眼压< 18 mmHg（标准2）之间，且无需额外的青光眼药物治疗、针刺治疗和滤过泡重建。采用Cox回归进行生存分析，以确定与术后效果相关的因素。
Trab组和EX组术前眼压分别为22.6±6.2 mmHg和21.8±6.0 mmHg（P = 0.507），6个月时分别为12.6±2.6 mmHg和14.0±4.4 mmHg（P = 0.06），12个月时分别为12.7±2.3 mmHg和12.9±2.8 mmHg（P = 0.678），18个月时分别为13.3±2.6 mmHg和12.6±2.8 mmHg（P = 0.260），24个月时分别为13.（此处原文有误，应是13）.2±2.3 mmHg和13.6±2.8 mmHg（P = 0.444）。Trab组和EX组眼压< 15 mmHg的比例在6个月时分别为82%和81%，12个月时分别为68%和62%，18个月时分别为63%和61%，24个月时分别为57%和53%。对数秩检验显示，两组在标准1（P = 0.755）和标准2（P = 0.138）方面无显著差异。多因素逻辑回归分析结果仅确定术前高眼压是手术失败的危险因素（标准1的比值比：1.076，P = 0.009；标准2的比值比：1.068，P = 0.048）。
Trab和EX的术后效果表明，在无需药物和干预的情况下，二者在使眼压低于15 mmHg和18 mmHg方面能力相似。
