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屈光性角膜消融术后开角型青光眼的视野进展

Visual field progression in open-angle glaucoma after refractive corneal ablation surgery.

作者信息

Tang Yu, Fan Xiang, Wang Minshu, Wu Lingling

机构信息

Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.

Department of Ophthalmology, Dalian Municipal Central Hospital, Dalian, China.

出版信息

Lasers Med Sci. 2023 Jan 30;38(1):57. doi: 10.1007/s10103-023-03709-1.

Abstract

This study aimed to investigate visual field (VF) progression in open-angle glaucoma (OAG) subjects who had a history of refractive corneal ablation surgery (RCAS). Retrospective study. The medical records of 21 subjects who had a history of refractive corneal ablation surgery (RCAS group) and 36 patients who had myopia without a history of RCAS (non-RCAS group) were reviewed. VF progression was determined by the non-parametric progression analysis (NPA) method. VF progression and clinical characteristics were compared between the two groups. For the RCAS group, refractive regressions were analysed. The mean follow-up periods were 4.5 years and 5.5 years for the RCAS and non-RCAS groups, respectively. More glaucoma subjects in the RCAS group (57.1%) had likely VF progression than in the non-RCAS group (25.0%) (p = 0.01). The RCAS group had a significantly lower percentage of IOP reduction with anti-glaucoma medication than the non-RCAS group (p = 0.037). Eyes with likely VF progression had a higher incidence of refractive regression (91.7%, 11/12) than eyes without it (33.3%, 3/9). Among subjects whose eyes had refractive regression, 78.6% (11/14) had likely VF progression, and 21.4% (3/14) did not (p = 0.016). The VF progression in OAG after RCAS was faster than that of myopic OAG without RCAS. Anti-glaucoma treatment should be actively enhanced in clinical practice.

摘要

本研究旨在调查有屈光性角膜消融手术(RCAS)史的开角型青光眼(OAG)患者的视野(VF)进展情况。回顾性研究。对21例有屈光性角膜消融手术史的患者(RCAS组)和36例无RCAS史的近视患者(非RCAS组)的病历进行了回顾。通过非参数进展分析(NPA)方法确定VF进展情况。比较两组之间的VF进展和临床特征。对于RCAS组,分析了屈光回退情况。RCAS组和非RCAS组的平均随访时间分别为4.5年和5.5年。RCAS组中可能出现VF进展的青光眼患者比例(57.1%)高于非RCAS组(25.0%)(p = 0.01)。RCAS组使用抗青光眼药物降低眼压的百分比显著低于非RCAS组(p = 0.037)。可能出现VF进展的眼睛的屈光回退发生率(91.7%,11/12)高于未出现VF进展的眼睛(33.3%,3/9)。在眼睛出现屈光回退的患者中,78.6%(11/14)可能出现VF进展,21.4%(3/14)未出现(p = 0.016)。RCAS术后OAG的VF进展比无RCAS的近视性OAG更快。临床实践中应积极加强抗青光眼治疗。

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