Department of Glaucoma, Dr. Shroff's Charity Eye Hospital, New Delhi, India.
Yenepoya Research Centre, Yenepoya (Deemed to be University), Derlakatte, Mangalore, Karnataka, India.
Indian J Ophthalmol. 2022 Oct;70(10):3569-3574. doi: 10.4103/ijo.IJO_656_22.
This study was done to report intermediate-term outcomes of irrigating goniectomy with trabectome (trabectome) surgery among different types of glaucoma eyes from a single center in India using a cross-sectional, longitudinal, observational study design.
Fifty-three patients (58 eyes) with glaucoma who underwent irrigating goniectomy with trabectome between January 2019 and February 2020 were included. Pre-operative data included age, gender, eye laterality, specific diagnosis, number of anti-glaucoma medications (AGMs), prior glaucoma surgeries, visual acuity, and intraocular pressure (IOP) on medical treatment. Post-operative data included IOP changes during the follow-up till 1-year, number of AGMs, any complications, or additional surgical intervention required. Success was defined as IOP ≤ 21 mmHg and ≥ 20% reduction of IOP from pre-operative IOP with no additional glaucoma surgery.
The cohort included 58 eyes (male 53.4% and female 46.6%) ranging from 0.6 to 81 years of age. The average baseline IOP was 23.4 ± 10.2 mmHg and reduced significantly with surgery to 14.1 ± 5.3 mmHg at 1-year follow-up. The AGMs reduced from 2.4 ± 1.4 pre-surgery to 1.6 ± 1.4 at 1-year follow-up. Four eyes required additional glaucoma surgeries for IOP control. The success rate of trabectome with phacoemulsification (88%) was discernibly higher than with trabectome alone (67%). Intra-operatively, significant blood reflux was noticed in 27 eyes, of which only one required tamponading with a viscoelastic agent.
This study concludes that irrigating goniectomy with trabectome has good efficacy and safety in both pediatric and adult cases of glaucoma in terms of IOP control, reduction in AGMs, and low incidence of complications in the Indian population.
本研究旨在报告在印度的一个单一中心，使用横断面、纵向、观察性研究设计，对不同类型青光眼眼进行经巩膜睫状体光凝切除术（trabectome）手术的中期结果。
纳入 2019 年 1 月至 2020 年 2 月期间接受经巩膜睫状体光凝切除术联合 trabectome 手术的 53 例（58 只眼）青光眼患者。术前数据包括年龄、性别、眼侧别、具体诊断、抗青光眼药物（AGM）数量、既往青光眼手术、视力和药物治疗时的眼压（IOP）。术后数据包括随访至 1 年时的 IOP 变化、AGM 数量、任何并发症或需要额外手术干预。成功定义为 IOP≤21mmHg 且与术前IOP 相比 IOP 降低≥20%，无需额外青光眼手术。
该队列包括 58 只眼（男性占 53.4%，女性占 46.6%），年龄从 0.6 岁至 81 岁不等。平均基线 IOP 为 23.4±10.2mmHg，术后显著降低至 1 年随访时的 14.1±5.3mmHg。AGM 从术前的 2.4±1.4 减少到 1 年随访时的 1.6±1.4。4 只眼因眼压控制需要额外的青光眼手术。与单独 trabectome 相比，联合白内障超声乳化的 trabectome 成功率（88%）明显更高（67%）。术中发现 27 只眼有明显的血液反流，其中仅 1 只眼需要用粘性剂填塞。
本研究得出结论，在印度人群中，经巩膜睫状体光凝切除术联合 trabectome 治疗青光眼具有良好的疗效和安全性，可有效控制眼压、减少 AGM，并降低并发症发生率，无论患者是儿童还是成人。
