Kim Yitak, Cho Won Jeong, Kim Jung Dong, Cho Hyuna, Bae Hyoung Won, Kim Chan Yun, Choi Wungrak
Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea.
Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul 03722, Korea.
J Clin Med. 2022 Aug 28;11(17):5057. doi: 10.3390/jcm11175057.
The most significant factor for endothelial cell loss should be readily identified, since prevention is the most crucial treatment. Here, we investigate risk factors for corneal endothelial cell density (ECD) decline following Ahmed glaucoma valve (AGV) implantation and determine the optimal cut-off values. This study included 103 eyes (95 patients) with glaucoma that underwent AGV implantation between January 2006 and January 2021 at a single medical center (Severance Hospital). We conducted consecutive -tests between two groups separated by the ECD change rate to determine the survival state of the enrolled patients. Associations were evaluated using univariable and multivariable linear regressions. Optimal cut-off values for identified risk factors were analyzed using a Cox proportional hazards model and a receiver operating characteristic (ROC) curve based on logistic regression. Mean follow-up duration was 4.09 ± 2.20 years. After implementing consecutive -tests, only patients with an ECD change rate greater than -6.1%/year were considered to have survived. Tube-iris distance (TID) was the only statistically significant factor identified in both the univariable and multivariable linear regressions. The cut-off value determined from the consecutive Cox regression method was 0.33 mm (smallest -value of 0.0087), and the cut-off value determined from the ROC method was 0.371 mm (area under the receiver operating characteristic curve [AUC], 0.662). Patients with short TIDs showed a better ECD prognosis following AGV surgery; we suggest optimal TID cut-off values of 0.33 mm and 0.371 mm based on the implemented Cox regression and ROC methodology, respectively.
由于预防是最关键的治疗方法，因此应易于确定导致内皮细胞丢失的最重要因素。在此，我们调查了艾哈迈德青光眼引流阀（AGV）植入术后角膜内皮细胞密度（ECD）下降的危险因素，并确定了最佳临界值。本研究纳入了2006年1月至2021年1月期间在单一医疗中心（Severance医院）接受AGV植入术的103只眼（95例患者）。我们对按ECD变化率分组的两组患者进行连续检验，以确定入组患者的生存状态。使用单变量和多变量线性回归评估相关性。使用Cox比例风险模型和基于逻辑回归的受试者工作特征（ROC）曲线分析已识别危险因素的最佳临界值。平均随访时间为4.09±2.20年。在进行连续检验后，仅将ECD变化率大于-6.1%/年的患者视为存活。管-虹膜距离（TID）是单变量和多变量线性回归中唯一确定的具有统计学意义的因素。通过连续Cox回归方法确定的临界值为0.33 mm（最小P值为0.0087），通过ROC方法确定的临界值为0.371 mm（受试者工作特征曲线下面积[AUC]为0.662）。TID短的患者AGV手术后ECD预后较好；我们分别基于所采用的Cox回归和ROC方法，建议最佳TID临界值为0.33 mm和0.371 mm。
