Department of Ophthalmology, University of California San Francisco, San Francisco, California.
Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania.
Ophthalmol Glaucoma. 2022 Sep-Oct;5(5):468-475. doi: 10.1016/j.ogla.2022.03.003. Epub 2022 Mar 15.
To evaluate the effect of postoperative topical prednisolone acetate and difluprednate on surgical outcomes of Ahmed glaucoma valve (AGV) implantation.
Retrospective, comparative case series.
The study population consisted of 102 eyes of 90 patients, including 52 eyes that received 1% prednisolone acetate (Pred Forte [PF]; Allergan Inc) and 50 eyes that received 0.05% difluprednate (Durezol [DZ]; Novartis Inc).
The medical records of consecutive patients who underwent AGV implantation at the University of California, San Francisco, were retrospectively reviewed. Patients in the PF group received 1% prednisolone acetate 6 to 8 times per day tapered over 5 to 6 months postoperatively, and patients in the DZ group received 0.05% difluprednate 4 times daily tapered over 4 months postoperatively.
Intraocular pressure (IOP), number of glaucoma medications, visual acuity (VA), postoperative complications, and the rate of treatment success.
At 1 year, the IOPs (mean ± standard deviation) were 12.4 ± 3.7 mmHg in the DZ group and 13.0 ± 4.0 mmHg in the PF group (P = 0.49). The numbers of glaucoma medications were 0.72 ± 0.71 in the DZ group and 1.09 ± 0.91 in the PF group (P = 0.04), with reductions from baseline of 2.5 ± 1.0 glaucoma medications in the DZ group and 1.8 ± 1.6 glaucoma medications in the PF group (P = 0.01). The logarithm of the minimum angle of resolution VAs (mean ± standard deviation) were 0.55 ± 0.80 in the DZ group and 0.59 ± 0.65 in the PF group after 1 year of follow-up (P = 0.81). The cumulative probabilities of success were 95.8% in the DZ group and 93.5% in the PF group at 1 year (P = 0.61). Postoperative complications occurred in 4 eyes (7.7%) in the DZ group and 6 eyes (12%) in the PF group (P = 0.52).
After 1 year, postoperative treatment with 0.05% difluprednate after AGV implantation resulted in a similar IOP, with the use of fewer glaucoma medications, compared with postoperative treatment with 1% prednisolone acetate. The rates of treatment success and surgical complications were comparable between the 2 groups during the first year of follow-up.
评估 Ahmed 青光眼引流阀（AGV）植入术后局部使用醋酸泼尼松龙和二氟泼尼酯对手术效果的影响。
回顾性、对比病例系列。
本研究人群包括 90 例患者的 102 只眼，其中 52 只眼接受 1%醋酸泼尼松龙（Pred Forte [PF]；Allergan Inc）治疗，50 只眼接受 0.05%二氟泼尼酯（Durezol [DZ]；诺华公司）治疗。
回顾性分析加利福尼亚大学旧金山分校连续接受 AGV 植入术的患者的病历。PF 组患者术后接受 1%醋酸泼尼松龙治疗，每天 6 至 8 次，持续 5 至 6 个月后逐渐减少剂量；DZ 组患者术后每天接受 0.05%二氟泼尼酯治疗，持续 4 个月后逐渐减少剂量。
眼内压（IOP）、青光眼药物使用数量、视力（VA）、术后并发症和治疗成功率。
1 年后，DZ 组的 IOP（平均值±标准差）为 12.4±3.7mmHg，PF 组为 13.0±4.0mmHg（P=0.49）。DZ 组的青光眼药物使用数量为 0.72±0.71，PF 组为 1.09±0.91（P=0.04），DZ 组和 PF 组的基线值分别为 2.5±1.0 种和 1.8±1.6 种青光眼药物（P=0.01）。DZ 组和 PF 组 1 年后的最小分辨角视力（VA）对数平均值（均数±标准差）分别为 0.55±0.80 和 0.59±0.65（P=0.81）。DZ 组和 PF 组 1 年时的累积成功率分别为 95.8%和 93.5%（P=0.61）。DZ 组有 4 只眼（7.7%）和 PF 组有 6 只眼（12%）发生术后并发症（P=0.52）。
1 年后，与术后使用 1%醋酸泼尼松龙相比，AGV 植入术后使用 0.05%二氟泼尼酯治疗可使 IOP 相似，但青光眼药物使用量更少。在随访的第一年，两组的治疗成功率和手术并发症发生率相当。
