Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Eye (Lond). 2023 Apr;37(6):1258-1263. doi: 10.1038/s41433-022-02087-2. Epub 2022 May 24.
BACKGROUND/OBJECTIVES: This study aimed to provide a 24-month follow-up on the surgical success and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) combined with phacoemulsification and intraocular lens (IOL) implantation in the treatment of patients with primary open-angle glaucoma (POAG) combined cataract.
SUBJECTS/METHODS: We included 124 consecutive cases of POAG with microcatheter-assisted GATT or GATT combined with phacoemulsification and IOL implantation at Beijing Tongren Eye Centre between October 2019 and November 2020. Main outcome measures included surgical success rate, changes in IOP, number of antiglaucoma medications, best corrected visual acuity (BCVA), postoperative complications at baseline, and follow-up period of up to 24 months.
In total, 58 eyes received GATT combined with phacoemulsification surgery and 66 eyes received GATT alone. The overall qualified success rate was 86.21% for eyes with GATT combined with phacoemulsification surgery, and 83.48% for eyes with GATT only at 24 months. IOP was reduced from 26.40 ± 6.37 mmHg on 3.12 ± 0.80 medications preoperatively to 14.61 ± 2.28 mmHg on 0.27 ± 0.71 medications at 12 months and 16.08 ± 2.38 mmHg on 0.45 ± 0.96 medications at 24 months after combined surgery. Additionally, mean BCVA improved from 0.75 ± 0.43 logMAR units preoperatively to 0.22 ± 0.18 logMAR units 24 months after combined surgery. No vision-threatening complications occurred during the 24-month follow-up.
The 24-month follow-up results of our study suggest that GATT combined with cataract surgery is a safe and effective treatment for decreasing IOP and number of medications in patients with POAG combined cataract.
背景/目的：本研究旨在提供 24 个月的随访结果，以评估青光眼引流阀辅助经巩膜睫状体光凝术（GATT）联合白内障超声乳化吸除术和人工晶状体（IOL）植入术治疗原发性开角型青光眼（POAG）合并白内障患者的手术成功率和安全性。
受试者/方法：我们纳入了 2019 年 10 月至 2020 年 11 月在北京同仁医院接受微导管辅助 GATT 或 GATT 联合白内障超声乳化吸除术和 IOL 植入术治疗的 124 例连续 POAG 患者。主要观察指标包括手术成功率、眼压（IOP）变化、降眼压药物使用数量、最佳矫正视力（BCVA）、术前和随访期间的术后并发症。
共有 58 只眼接受了 GATT 联合白内障超声乳化吸除术，66 只眼仅接受了 GATT。GATT 联合白内障超声乳化吸除术的总合格成功率为 86.21%，GATT 单独手术的成功率为 83.48%，随访 24 个月。IOP 从术前的 26.40 ± 6.37mmHg 和 3.12 ± 0.80 种降眼压药物降至术后 12 个月的 14.61 ± 2.28mmHg 和 0.27 ± 0.71 种药物，术后 24 个月的 16.08 ± 2.38mmHg 和 0.45 ± 0.96 种药物。此外，平均 BCVA 从术前的 0.75 ± 0.43logMAR 单位提高到术后 24 个月的 0.22 ± 0.18logMAR 单位。在 24 个月的随访期间，没有发生威胁视力的并发症。
本研究的 24 个月随访结果表明，GATT 联合白内障手术是一种安全有效的治疗方法，可以降低 POAG 合并白内障患者的眼压和药物使用数量。
