Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
J Glaucoma. 2024 Aug 1;33(8):559-565. doi: 10.1097/IJG.0000000000002391. Epub 2024 Apr 9.
Analysis of surgical success and intraocular pressure (IOP), best-corrected visual acuity (BCVA), and antiglaucomatous medication (AGM) changes between segmental 180-degree and 360-degree gonioscopy-assisted transluminal trabeculectomy (GATT) in patients with pseudoexfoliation glaucoma (PEXG) showed no significant difference.
To compare surgical outcomes of segmental 180-degree and 360-degree GATT in patients with PEXG.
Prospective, comparative study of 65 PEXG eyes, who underwent segmental 180-degree GATT (GATT 180-degree group, 31 eyes) and 360-degree GATT (GATT 360-degree group, 34 eyes) in a tertiary academic center over a 12-month of follow-up. Primary outcome was qualified and complete surgical success rates for criterion A (IOP <18 mm Hg and >30% reduction) and criterion B (IOP <15 mm Hg and >30% reduction). Secondary outcome measures included IOP reduction, BCVA change, AGM use, and postoperative complications.
The probabilities of qualified and complete success rates both for criteria A and B did not significantly differ between the groups ( P > 0.05). IOP and BCVA levels were similar at each time point ( P > 0.05). IOP reduction was 59.3 ± 9.5% in the GATT 180-degree group and 55.8 ± 18.1% in the GATT 360-degree group ( P = 0.33). No significant difference in the mean number of AGM was present at the 12-month visit (1.2 ± 1.1 in GATT 180-degree group vs 1.5 ± 1.2 in GATT 360-degree group, P = 0.25). Significantly higher incidences of postoperative hyphema and IOP spikes were observed in the GATT 360-degree group ( P = 0.01 and P = 0.008, respectively).
Both segmental 180-degree and 360-degree GATT similarly reduced IOP and AGM with comparable surgical success rates in patients with PEXG at the end of 12 months. Postoperative hyphema and IOP spike rates were significantly higher after 360-degree GATT. Segmental 180-degree GATT may be sufficient to adequately modulate IOP with a lower incidence of postoperative complications in PEXG.
在患有假性剥脱性青光眼（PEXG）的患者中，分析 180 度节段性和 360 度房角镜辅助经小梁切除术（GATT）之间的手术成功率和眼内压（IOP）、最佳矫正视力（BCVA）和抗青光眼药物（AGM）变化，结果无显著差异。
比较 180 度节段性和 360 度 GATT 在 PEXG 患者中的手术效果。
前瞻性、比较性研究，纳入在一家三级学术中心接受 180 度节段性 GATT（GATT 180 度组，31 眼）和 360 度 GATT（GATT 360 度组，34 眼）的 65 只 PEXG 眼，随访 12 个月。主要结局为标准 A（IOP <18 mmHg 和 >30%降低）和标准 B（IOP <15 mmHg 和 >30%降低）的合格和完全手术成功率。次要结局指标包括 IOP 降低、BCVA 变化、AGM 使用和术后并发症。
两组的标准 A 和 B 的合格和完全成功率的概率均无显著差异（P > 0.05）。在每个时间点，IOP 和 BCVA 水平均相似（P > 0.05）。GATT 180 度组的 IOP 降低率为 59.3 ± 9.5%，GATT 360 度组为 55.8 ± 18.1%（P = 0.33）。在 12 个月的随访中，AGM 的平均数量没有显著差异（GATT 180 度组为 1.2 ± 1.1，GATT 360 度组为 1.5 ± 1.2，P = 0.25）。GATT 360 度组术后发生较高的前房积血和眼压升高的发生率（P = 0.01 和 P = 0.008）。
在 12 个月时，在患有 PEXG 的患者中，180 度节段性和 360 度 GATT 同样降低了 IOP，并具有相似的手术成功率。在 360 度 GATT 后，术后前房积血和眼压升高的发生率明显更高。在 PEXG 中，180 度节段性 GATT 可能足以充分调节 IOP，且术后并发症发生率较低。
