Saha Rini, Dharia Riddhi Shah, Trope Graham E, Buys Yvonne M
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
Department of Glaucoma, Iris Superspeciality Eye Hospital, Ranchi, Jharkhand, India.
J Curr Ophthalmol. 2022 Jul 26;34(2):167-172. doi: 10.4103/joco.joco_244_21. eCollection 2022 Apr-Jun.
To evaluate the effect of prophylactic aqueous suppressants immediately post-Ahmed glaucoma valve (AGV) surgery on the rate of hypertensive phase and success.
Retrospective case-control study of 80 eyes with refractory glaucoma undergoing AGV surgery. Forty eyes in the intervention group (preoperative aqueous suppressants continued postoperatively) and 40 in the control group (all glaucoma drops stopped after surgery and reintroduced as required) were included in this study. Patients were followed for 1 year. Data collected included intraocular pressure (IOP), number of glaucoma medications, and number of eyes requiring further IOP lowering surgery. The frequency of hypertensive phase and 1-year success was compared between the groups.
Hypertensive phase occurred in 22.5% of the intervention group compared to 42.5% of the control group; however, this difference was not statistically significant ( = 0.06). Success at 1 year (IOP ≤21 mmHg but ≥5 mmHg and 20% reduction from baseline without additional surgery) was similar in each group: 77.5% in the intervention group and 62.5% in the control group ( = 0.22). However, at 1 year, significantly more eyes in the intervention group had an IOP ≤17 mmHg (95% vs. 80%, = 0.04). The mean time interval to a second IOP lowering procedure was significantly shorter in the control group ( < 0.005).
With prophylactic preoperative aqueous suppressants, more eyes achieved an IOP of ≤17 mmHg. The time interval to repeat the glaucoma procedure was significantly shorter in the control group.
评估在艾哈迈德青光眼引流阀（AGV）手术后立即使用预防性房水生成抑制剂对高血压期发生率及手术成功率的影响。
对80例接受AGV手术的难治性青光眼患者进行回顾性病例对照研究。本研究纳入干预组40眼（术后继续使用术前房水生成抑制剂）和对照组40眼（术后停用所有青光眼药物，根据需要重新使用）。对患者进行为期1年的随访。收集的数据包括眼压（IOP）、青光眼药物使用数量以及需要进一步降低眼压手术的眼数。比较两组高血压期的发生率和1年成功率。
干预组高血压期发生率为22.5%，对照组为42.5%；然而，这一差异无统计学意义（P = 0.06）。两组1年成功率（眼压≤21 mmHg但≥5 mmHg且较基线降低20%且无需额外手术）相似：干预组为77.5%，对照组为62.5%（P = 0.22）。然而，在1年时，干预组眼压≤17 mmHg的眼数显著更多（95%对80%，P = 0.04）。对照组进行第二次降低眼压手术的平均时间间隔显著更短（P < 0.005）。
使用预防性术前房水生成抑制剂时，更多眼的眼压≤17 mmHg。对照组重复青光眼手术的时间间隔显著更短。
