Oogi Satomi, Nakakura Shunsuke, Asaoka Ryo, Terao Etsuko, Dote Saki, Matsuya Kanae, Kimura Yui
Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.
Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
Front Med (Lausanne). 2022 Feb 21;9:847660. doi: 10.3389/fmed.2022.847660. eCollection 2022.
To investigate the effect of microincision vitreous surgery (MIVS) on intraocular pressure (IOP) control in glaucomatous eyes with functional filtering bleb.
We enrolled 18 patients (15 males; median age, 73 years) who previously had filtering surgery and underwent MIVS with functional filtering bleb. Kaplan-Meier method was used to calculate the survival rate with defined the failure as when more number of preoperative antiglaucoma medication was started or additional glaucoma surgery including bleb revisions were performed, and IOP increase of 20% (criteria 1) and 30% (criteria 2) from preoperative levels after 2 weeks of MIVS.
The median follow-up duration was 970 days. Preoperative IOP was 13.3 ± 3.8 mmHg (mean ± SD). Postoperative IOP were 14.7 ± 4.9 (=0.365), 15.2 ± 3.5 (=0.137), 16.4 ± 5.6 ( = 0.073), 17.6 ± 6.1( = 0.020), and 14.5 ± 4.0 ( = 0.402) mmHg at 3, 6, 12, and 15 months and final visit, respectively (compared to preoperative IOP). The number of antiglaucoma medications was a median of 1.0 (range 0-4) preoperatively and 0 (0-4) at the final visit ( = 0.238). The survival rates were 55%/61% at 3 months, 50%/61% at 6 months, and 38%/55% at 12 months with criteria 1 and 2, respectively. Four eyes (22%) received additional glaucoma surgery during follow-up.
After several months of MIVS, IOP was likely to increase. We should focus on IOP control by conducting long-term follow-ups.
探讨微切口玻璃体手术（MIVS）对伴有功能性滤过泡的青光眼患眼眼压（IOP）控制的影响。
我们纳入了18例患者（15例男性；中位年龄73岁），这些患者先前接受过滤过手术，并对伴有功能性滤过泡的患眼进行了MIVS。采用Kaplan-Meier法计算生存率，将开始使用更多术前抗青光眼药物或进行包括滤过泡修复在内的额外青光眼手术，以及MIVS术后2周眼压较术前水平升高20%（标准1）和30%（标准2）定义为失败。
中位随访时间为970天。术前眼压为13.3±3.8 mmHg（均值±标准差）。术后3、6、12和15个月以及末次随访时的眼压分别为14.7±4.9（P=0.365）、15.2±3.5（P=0.137）、16.4±5.6（P=0.073）、17.6±6.1（P=0.020）和14.5±4.0（P=0.402）mmHg（与术前眼压相比）。抗青光眼药物的数量术前中位数为1.0（范围0 - 4），末次随访时为0（0 - 4）（P=0.238）。采用标准1和标准2时，3个月时的生存率分别为55%/61%，6个月时为50%/61%，12个月时为38%/55%。4只眼（22%）在随访期间接受了额外的青光眼手术。
MIVS术后数月眼压可能会升高。我们应通过长期随访关注眼压控制。
