University Hospitals of Cleveland Eye Institute and Department of Ophthalmology and Visual Sciences, Case Western Reserve University, School of Medicine, Cleveland, OH.
Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH.
J Glaucoma. 2024 Sep 1;33(9):671-678. doi: 10.1097/IJG.0000000000002453. Epub 2024 Jun 17.
About one-fourth of survey respondents from an ASCRS database initiate treatment for primary open angle glaucoma (POAG) with laser trabeculoplasty. Factors impacting physicians' choice of laser versus topical treatment for POAG were explored.
To characterize primary treatment preferences (topical medication versus laser trabeculoplasty or intracameral sustained release implants) in primary open angle glaucoma (POAG) patients and determine factors related to primary intervention selection.
A 33-question survey was distributed to an American Society of Cataract and Refractive Surgery database on treatment choices made by ophthalmologists for POAG. Data collected included country of practice, years of practice, completion of glaucoma fellowship training, type of practice, and preference for the first line of treatment for POAG. Multiple logit regression was used to compare the effect of covariates on physicians' choice of either topical medication or laser trabeculoplasty for POAG.
A total of 252 of 19,246 (1.3%) surveys were returned. Almost three-quarters of respondents used topical medication as the first line of treatment for POAG (73.6%), whereas 26.4% preferred to start with laser treatment. Significant variables associated with the selection of laser (vs. drops) are practicing in the United States (odds ratio [OR] 2.85; 95% CI, 1.33-6.10), the more recent completion of ophthalmology residency (OR 1.95; 95% CI, 1.00-3.77), the greater volume of minimally invasive glaucoma surgeries (MIGS) (OR 1.68; 95% CI, 1.18-2.40), and a glaucoma patient base greater than 25% (OR 2.21; 95% CI, 1.09-4.48).
For the first-line treatment of POAG, laser trabeculoplasty is more likely to be preferred, over topical drops, by U.S. physicians who are relatively new in practice, who have a larger glaucoma patient base, and who perform more MIGS.
在美国白内障与屈光手术学会（ASCRS）数据库中，约有四分之一的调查对象因原发性开角型青光眼（POAG）而开始接受激光小梁成形术治疗。本研究旨在探讨影响医生选择激光治疗与局部治疗 POAG 的因素。
描述原发性开角型青光眼（POAG）患者的主要治疗偏好（局部药物治疗与激光小梁成形术或眼内持续释放植入物），并确定与主要干预措施选择相关的因素。
向美国白内障与屈光手术学会数据库中的眼科医生分发了一份关于 POAG 治疗选择的 33 个问题的调查问卷。收集的数据包括执业国家、执业年限、是否完成青光眼专科培训、执业类型以及 POAG 一线治疗的首选。采用多项逻辑回归比较协变量对眼科医生选择 POAG 局部药物治疗或激光小梁成形术的影响。
共收回 19246 份调查中的 252 份（1.3%）。近四分之三的受访者（73.6%）将局部药物作为 POAG 的一线治疗，而 26.4%的受访者首选激光治疗。与选择激光（而非滴眼剂）相关的显著变量包括在美国执业（优势比[OR] 2.85；95%可信区间[CI]，1.33-6.10）、最近完成眼科住院医师培训（OR 1.95；95% CI，1.00-3.77）、微创青光眼手术（MIGS）量较大（OR 1.68；95% CI，1.18-2.40）和青光眼患者基数大于 25%（OR 2.21；95% CI，1.09-4.48）。
对于 POAG 的一线治疗，美国执业时间较短、青光眼患者基数较大且实施更多 MIGS 的医生更倾向于选择激光小梁成形术，而非局部滴眼剂。
