Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria.
Department of Dentistry and Oral Health, Medical University Graz, 8036 Graz, Austria.
Int J Environ Res Public Health. 2023 Feb 2;20(3):2666. doi: 10.3390/ijerph20032666.
As the number of surgical options in glaucoma treatment is continuously rising, evidence regarding distinctive features of these surgeries is becoming more and more important for clinicians to choose the right surgical treatment for each individual patient.
For this retrospective data analysis, we included glaucoma patients treated with either continuous wave (CW-TSCPC) or micropulse transscleral cyclophotocoagulation (MP-TSCPC) in an inpatient setting. Pain intensity was assessed using a numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst imaginable pain) during hospitalization. CW-TSCPC was performed using OcuLight Six (IRIDEX Corporation, Mountain View, CA, USA) and MP-TSCPC was performed using the IRIDEX Cyclo-G6 System (IRIDEX Corporation, Mountain View, CA, USA).
A total of 243 consecutive cases of TSCPC were included. Of these, 144 (59.26%) were treated with CW-TSCPC and 99 (40.74%) with MP-TSCPC. Using the univariable model, the risk for postoperative pain was observed to be lower in MP-TSCPC compared with CW-TSCPC (unadjusted: OR 0.46, 95% CI 0.24-0.84, = 0.017), but this did not hold using the multivariable model (adjusted: OR 0.52, 95% CI 0.27-1.02, = 0.056). Simultaneously conducted anterior retinal cryotherapy was associated with a higher risk for postoperative pain (OR 4.41, 95% CI 2.01-9.69, < 0.001).
We found that the occurrence of postoperative pain was not different in CW-TSCPC compared with MP-TSCPC in a multivariable model. In cases of simultaneous anterior retinal cryotherapy, the risk for postoperative pain was significantly higher.
随着青光眼治疗手术选择的不断增加,这些手术的独特特征的证据对于临床医生为每个患者选择正确的手术治疗方法变得越来越重要。
在这项回顾性数据分析中,我们纳入了在住院期间接受连续波(CW-TSCPC)或微脉冲经巩膜睫状体光凝术(MP-TSCPC)治疗的青光眼患者。使用数字评分量表(NRS)评估住院期间的疼痛强度,范围从 0(无痛)到 10(可想象的最严重疼痛)。CW-TSCPC 使用 OcuLight Six(IRIDEX Corporation,Mountain View,CA,USA)进行,MP-TSCPC 使用 IRIDEX Cyclo-G6 系统(IRIDEX Corporation,Mountain View,CA,USA)进行。
共纳入 243 例连续 TSCPC 病例。其中,144 例(59.26%)接受 CW-TSCPC 治疗,99 例(40.74%)接受 MP-TSCPC 治疗。使用单变量模型,与 CW-TSCPC 相比,MP-TSCPC 术后疼痛的风险较低(未调整:OR 0.46,95%CI 0.24-0.84, = 0.017),但使用多变量模型时则不然(调整:OR 0.52,95%CI 0.27-1.02, = 0.056)。同时进行的前部视网膜冷冻治疗与术后疼痛的风险增加相关(OR 4.41,95%CI 2.01-9.69, < 0.001)。
我们发现,多变量模型中 CW-TSCPC 与 MP-TSCPC 相比,术后疼痛的发生并无差异。在同时进行前部视网膜冷冻治疗的情况下,术后疼痛的风险显著增加。