Department of Glaucoma, Aravind Eye Hospital and Post-Graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
Department of Paediatric Ophthalmology and Strabismus, Aravind Eye Hospital and Post-Graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
Indian J Ophthalmol. 2022 May;70(5):1635-1641. doi: 10.4103/ijo.IJO_2876_21.
To assess the long-term outcomes of choroidal detachments (CDs) in eyes following trabeculectomy.
Retrospective comparative case series. Data of patients with CDs following trabeculectomy (5-year period) with or without cataract surgery with a minimum of 3 months of follow-up were included.
In total, 45 patients with CDs following trabeculectomy were included. The mean age was 63.27 ± 8.68 years, (M:F = 2:1); 29 of 45 eyes (64.4%) had a baseline IOP of >24 mm Hg. Patients had a median follow-up of 22.2 (IQR: 16.2-30.5) months. Further, 10 of 45 eyes (22.2%) had CDs following suture lysis. The median onset of choroidal detachment from the time of surgery was 16.0 (IQR: 11-36) days. The mean BCVA improved from 0.62 ± 0.28 to 0.24 ± 0.27 (P < 0.001) and mean IOP increased from 4.07 ± 2.66 to 11.20 ± 5.31 (P < 0.001) at last visit. The cumulative success rates were 76.4% (95% CI: 48.4-90.5) in POAG eyes and 79.3% (95% CI: 62.8-89.1) in PACG eyes (P = 0.547). Medical management was the mainstay in all patients. Four of 45 (8.88%) patients underwent subsequent choroidal drainage.
Choroidal detachment following modern-day trabeculectomy has favorable long-term visual acuity and IOP outcomes. There was no difference in the long-term surgical success of trabeculectomy with choroidal detachments in primary angle-closure and open-angle glaucoma eyes. Long-term follow-up is essential to prevent chronic hypotony and trabeculectomy failure.
评估青光眼滤过术后脉络膜脱离（CD）的长期结果。
回顾性对比病例系列。纳入了青光眼滤过术后（5 年期间）伴有或不伴有白内障手术且随访时间至少 3 个月的伴有 CD 的患者的数据。
共纳入 45 例青光眼滤过术后发生 CD 的患者。平均年龄为 63.27 ± 8.68 岁（男女比为 2:1）；45 只眼中 29 只（64.4%）基线眼压（IOP）>24mmHg。患者的中位随访时间为 22.2（IQR：16.2-30.5）个月。此外，45 只眼中有 10 只（22.2%）在缝线松解后发生 CD。脉络膜脱离从手术开始的中位时间为 16.0（IQR：11-36）天。最佳矫正视力（BCVA）从 0.62 ± 0.28 提高到 0.24 ± 0.27（P<0.001），平均 IOP 从 4.07 ± 2.66 升高至 11.20 ± 5.31（P<0.001）。在最后一次随访时，POAG 眼的累积成功率为 76.4%（95%CI：48.4-90.5），PACG 眼为 79.3%（95%CI：62.8-89.1）（P=0.547）。所有患者均以药物治疗为主。45 例患者中有 4 例（8.88%）接受了后续脉络膜引流。
现代青光眼滤过术后发生脉络膜脱离具有良好的长期视力和眼压结局。在原发性闭角型和开角型青光眼眼中，伴有脉络膜脱离的青光眼滤过术的长期手术成功率无差异。长期随访对于预防慢性低眼压和滤过失败至关重要。
