Sakai Daiki, Fujihara Masashi, Yokota Satoshi, Nakamura Makoto, Kurimoto Yasuo
Department of Ophthalmology, Kobe City Eye Hospital, Kobe 650-0047, Japan.
Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe 650-0047, Japan.
Int J Ophthalmol. 2022 Apr 18;15(4):598-603. doi: 10.18240/ijo.2022.04.12. eCollection 2022.
To investigate the one-year outcomes and factors that influence the results of microhook trabeculotomy (µLOT).
The medical records of consecutive patients with open angle glaucoma who underwent µLOT (including combination of µLOT and cataract surgery) between February 2018 and July 2019 were retrospectively reviewed. Surgical success was defined as the following: an intraocular pressure (IOP)≤21 mm Hg or IOP≤preoperative IOP with a reduced number of glaucoma eye drops, without additional glaucoma surgery, and assessed using Kaplan-Meier survival analysis. A multivariate Cox proportional-hazards regression model was used to investigate the factors associated with surgical failure.
The 59 eyes of 59 patients comprising 28 eyes with primary open angle glaucoma (POAG) and 31 with secondary open angle glaucoma (SOAG) were included. The mean IOP and number of glaucoma eye drops significantly decreased from 25.3±7.2 mm Hg and 3.9±1.1, preoperatively to 16.1±4.4 mm Hg (<0.01) and 2.1±1.8 (<0.01), respectively, 12mo postoperatively, with a cumulative success rate of 63.1%. The one-year success rate was significantly higher in POAG eyes than in SOAG eyes (80.0% 48.0%; =0.011, log-rank test). Multivariate analyses revealed SOAG [=0.017, adjusted hazard ratio (aHR): 3.468, 95%CI: 1.246-9.654] and the postoperative IOP spike (IOP>25 mm Hg within 2wk post-surgery; <0.001, aHR: 5.382, 95%CI: 2.113-13.707) as independent factors associated with surgical failure.
The µLOT is a good treatment option for POAG eyes. However, the postoperative course should be carefully followed in cases with postoperative IOP spike.
研究微钩小梁切开术（µLOT）的一年疗效及影响手术结果的因素。
回顾性分析2018年2月至2019年7月期间连续接受µLOT手术（包括µLOT联合白内障手术）的开角型青光眼患者的病历。手术成功定义为：眼压（IOP）≤21 mmHg或IOP≤术前眼压，且青光眼滴眼液使用次数减少，无需额外的青光眼手术，并采用Kaplan-Meier生存分析进行评估。采用多变量Cox比例风险回归模型研究与手术失败相关的因素。
纳入59例患者的59只眼，其中原发性开角型青光眼（POAG）28只眼，继发性开角型青光眼（SOAG）31只眼。术后12个月时，平均眼压和青光眼滴眼液使用次数分别从术前的25.3±7.2 mmHg和3.9±1.1显著降至16.1±4.4 mmHg（<0.01）和2.1±1.8（<0.01），累积成功率为63.1%。POAG组的一年成功率显著高于SOAG组（80.0%对48.0%；P=0.011，对数秩检验）。多变量分析显示，SOAG（P=0.017，调整后风险比[aHR]：3.468，95%置信区间[CI]：1.246-9.654）和术后眼压峰值（术后2周内IOP>25 mmHg；P<0.001，aHR：5.382，95%CI：2.113-13.707）是与手术失败相关的独立因素。
µLOT是POAG患者的一种良好治疗选择。然而，对于术后出现眼压峰值的患者，应密切随访术后病程。
