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三种微钩行小梁切开术 1 年手术效果比较。

Comparison of the 1-year surgical outcomes of trabeculotomy using three types of microhooks.

机构信息

Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.

Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Osaka, Japan.

出版信息

Eur J Ophthalmol. 2024 Mar;34(2):461-470. doi: 10.1177/11206721231189111. Epub 2023 Jul 25.

Abstract

PURPOSE

We compared the 1-year surgical outcomes of microhook trabeculotomy (μLOT) using three types of microhooks.

METHODS

We retrospectively analyzed 81 eyes that underwent μLOT, in which three microhooks, the Sinskey hook, Tanito Micro-Hook-trabeculotomy-device (TMH), and Matsushita ed. TMH, were used. We collected the data from the medical records. We analyzed the success rates and risk factors. Failure was defined as the need for additional surgery for IOP reduction, loss of light perception, and IOP ≧22 mmHg and IOP reduction <20% (definition 1), IOP ≧17 mmHg and IOP reduction <20% (definition 2), IOP ≧15 mmHg and IOP reduction <25% (definition 3), or IOP ≧12 mmHg and IOP reduction <30% (definition 4) at two consecutive follow-up visits.

RESULTS

Twenty-six eyes underwent μLOT using the Sinskey microhook (group S), 21 eyes using the TMH (group T), and 34 eyes using the Matsushita ed. TMH (group M). The mean postoperative IOP and IOP-lowering medication score decreased significantly. The respective success rates among groups S, T, and M did not differ significantly (definition 1, 65.4%, 61.9%, and 55.9%; definition 2, 42.3%, 47.6%, and 32.3%; definition 3, 15.4%, 28.6%, and 23.5%; definition 4, 0%, 9.5%, and 2.9%). In group S, the hyphema-related IOP spikes decreased within 2 weeks postoperatively, and in group M, the non-hyphema-related IOP spikes decreased significantly.

CONCLUSION

The 1-year surgical outcomes and complications after μLOT did not differ significantly among the three microhooks. The differences in the microhook tips might be associated with postoperative transient IOP spikes.

摘要

目的

我们比较了使用三种不同微钩的微钩小梁切开术(μLOT)的一年手术效果。

方法

我们回顾性分析了 81 只接受 μLOT 的眼睛,其中使用了三种微钩,即 Sinskey 钩、Tanito Micro-Hook-trabeculotomy-device(TMH)和松下 ed. TMH。我们从病历中收集数据。我们分析了成功率和危险因素。失败定义为需要额外手术以降低眼压、光感丧失以及眼压≥22mmHg 且眼压降低<20%(定义 1)、眼压≥17mmHg 且眼压降低<20%(定义 2)、眼压≥15mmHg 且眼压降低<25%(定义 3)或眼压≥12mmHg 且眼压降低<30%(定义 4),在两次连续随访中。

结果

26 只眼睛接受了 Sinskey 微钩的 μLOT(组 S),21 只眼睛接受了 TMH(组 T),34 只眼睛接受了松下 ed. TMH(组 M)。术后平均眼压和降眼压药物评分均显著降低。组 S、T 和 M 的成功率无显著差异(定义 1,65.4%、61.9%和 55.9%;定义 2,42.3%、47.6%和 32.3%;定义 3,15.4%、28.6%和 23.5%;定义 4,0%、9.5%和 2.9%)。在组 S 中,术后 2 周内与血有关的眼压峰值下降,而在组 M 中,与血无关的眼压峰值显著下降。

结论

三种微钩的μLOT 术后一年的手术效果和并发症无显著差异。微钩尖端的差异可能与术后短暂的眼压峰值有关。

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