Eastern Virginia Medical School, Norfolk, VA.
Johns Hopkins University School of Medicine, Baltimore, MD.
Medicine (Baltimore). 2023 Nov 24;102(47):e36006. doi: 10.1097/MD.0000000000036006.
To evaluate how well outcomes following cataract extraction and microinvasive glaucoma surgery in one eye predict outcomes in sequential second eye. Retrospective study of 78 patients who underwent cataract extraction and microinvasive glaucoma surgery in both eyes. Linear regressions using Pearson correlation coefficients were used to evaluate correlations in intraocular pressure and glaucoma medication change between eyes. Multivariable logistic regression models were used to evaluate the associations between first-eye variables and the likelihood of second-eye surgical success at 6 months. Surgical success was defined as meeting target intraocular pressure without additional medications compared to baseline or secondary surgical interventions. Baseline ocular characteristics were comparable between fellow eyes, with the majority having mild glaucoma. Intraocular pressure changes between fellow eyes at 6 months were modestly correlated between eyes (R = 0.48; P < .001). Changes in glaucoma medications were strongly correlated between eyes at all time points, and month 6 demonstrated the most significant correlation (R = 0.80; P < .001). First and second eye cohorts achieved 82% and 83% surgical success. Multivariate analysis for predictive factors of successful second eye surgery showed patients with successful first eye surgery at 6 months were significantly more likely to have successful second eye surgery (odds ratio, 20.67; P < .001). Reductions in intraocular pressure and glaucoma medications at 6 months following surgery in first eyes are correlated to second eye reductions. Successful surgical outcomes at 6 months following first eye surgeries are strongly associated with successful sequential second eye outcomes.
评估一眼白内障摘除和微创新式青光眼手术后的结果对后续第二眼结果的预测效果。对 78 例双眼白内障摘除和微创新式青光眼手术的患者进行回顾性研究。使用皮尔逊相关系数的线性回归来评估双眼之间眼压和青光眼药物变化的相关性。使用多变量逻辑回归模型评估第一眼变量与 6 个月时第二眼手术成功率的关联。手术成功定义为与基线或二次手术干预相比，目标眼压无需额外药物治疗。对侧眼的基线眼部特征在统计学上相似，大多数为轻度青光眼。6 个月时对侧眼的眼压变化在统计学上呈中度相关（R=0.48；P<.001）。在所有时间点，青光眼药物的变化在统计学上都与对侧眼高度相关，6 个月时相关性最强（R=0.80；P<.001）。第一眼和第二眼队列的手术成功率分别为 82%和 83%。预测第二眼手术成功的多变量分析显示，6 个月时第一眼手术成功的患者第二眼手术成功的可能性显著更高（优势比，20.67；P<.001）。第一只眼手术后 6 个月眼压和青光眼药物的降低与第二只眼的降低相关。第一只眼手术后 6 个月的手术成功结果与后续第二只眼的成功结果密切相关。
