Almobarak Faisal A, Alrubean Ahmed, Alsarhani Waleed K, Aljenaidel Abdullah, Osman Essam
Department of Ophthalmology, College of Medicine, King Saud University, P.O. Box 245, Riyadh, 11411, Saudi Arabia.
Glaucoma Research Chair, King Saud University, Riyadh, Saudi Arabia.
Ophthalmol Ther. 2022 Aug;11(4):1601-1610. doi: 10.1007/s40123-022-00538-3. Epub 2022 Jun 25.
The purpose of this study is to report the outcomes and complications of ultrasound cyclo plasty (UCP) after failed glaucoma surgery.
A retrospective case series included patients with previously failed glaucoma surgery who underwent UCP at King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, between 2016 and 2021. The main outcome measures were: intraocular pressure (IOP), number of antiglaucoma medications and presence of vision-threatening complications. The surgical outcome of each eye was based on the main outcome measures.
Seventy eyes of 70 patients were included in the study. The mean follow-up period was 31.89 months (± 17.5). The IOP and the number of antiglaucoma medications decreased significantly from a mean of 23.91 mmHg (± 6.3) and 3.43 (± 0.8) to 17.88 mmHg (± 8.1) and 2.48 (± 1.3) and of 16.74 (± 7.9) and 2.11 (± 1.3) at the 12th and 24th months postoperatively, respectively (p < 0.01 for both). The success rates were 77.1% (54/70) and 48.6% (34/70), while the failure rates were 22.9% (16/70) and 2.9% (2/70) at the 12th and 24th months postoperatively, respectively. The cumulative probabilities of success were 70.0% (± 5.5%) and 47.1% (± 6.0%) at the 12th and 24th months postoperatively, respectively. The most common complications were anterior chamber reaction (24.3%), cataract development/progression (18.6%), hypotony/choroidal detachment (4.3%), phthisis bulbi (1.4%) and aqueous misdirection (1.4%).
UCP is an effective treatment modality to control IOP and decrease the burden of antiglaucoma medications in eyes with previously failed glaucoma surgery. Monitoring and counseling of possible postoperative complications are needed.
本研究旨在报告青光眼手术失败后超声睫状体成形术（UCP）的疗效及并发症。
一项回顾性病例系列研究纳入了2016年至2021年间在沙特阿拉伯利雅得阿卜杜勒阿齐兹国王大学医院接受UCP治疗的青光眼手术先前失败的患者。主要观察指标包括：眼压（IOP）、抗青光眼药物数量以及是否存在威胁视力的并发症。每只眼睛的手术效果均基于主要观察指标进行评估。
该研究共纳入70例患者的70只眼睛。平均随访时间为31.89个月（±17.5）。术后12个月和24个月时，眼压和抗青光眼药物数量均显著下降，眼压从平均23.91 mmHg（±6.3）降至17.88 mmHg（±8.1），抗青光眼药物数量从平均3.43（±0.8）降至2.48（±1.3），术后24个月时眼压进一步降至16.74（±7.9），抗青光眼药物数量降至2.11（±1.3）（两者p均<0.01）。术后12个月和24个月时的成功率分别为77.1%（54/70）和48.6%（34/70），失败率分别为22.9%（16/70）和2.9%（2/70）。术后12个月和24个月时的累积成功概率分别为70.0%（±5.5%）和47.1%（±6.0%）。最常见的并发症为前房反应（24.3%）、白内障发生/进展（18.6%）、低眼压/脉络膜脱离（4.3%）、眼球痨（1.4%）和房水错流（1.4%）。
超声睫状体成形术是控制青光眼手术先前失败的眼睛眼压并减轻抗青光眼药物负担的一种有效治疗方式。需要对可能的术后并发症进行监测和咨询。
