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眼变形在 Corvis ST 测量中预测青光眼术后低眼压并发症的有用性。

Usefulness of Eye Deformation in the Corvis ST Measurement to Predict Postoperative Hypotony Complications in Glaucoma.

机构信息

From the Department of Ophthalmology (R.A., A.O.), Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan; Seirei Christopher University (R.A.), Hamamatsu, Shizuoka, Japan; The Graduate School for the Creation of New Photonics Industries, Hamamatsu 431-1202, Shizuoka, Japan; Organization for Innovation and Social Collaboration, National University Corporation Shizuoka University, Hamamatsu, Shizuoka, Japan.

Department of Ophthalmology (S.N.), Saneikai Tsukazaki Hospital, Hyogo, Japan.

出版信息

Am J Ophthalmol. 2024 Dec;268:66-75. doi: 10.1016/j.ajo.2024.07.031. Epub 2024 Jul 31.

Abstract

PURPOSE

This study aimed to investigate the usefulness of measuring biomechanical parameters using the Corvis ST to predict the occurrence of hypotony maculopathy and choroidal detachment (CD) following trabeculectomy or bleb needling revision with mitomycin C.

DESIGN

Clinical cohort study.

METHODS

This study included 100 eyes of 100 patients who underwent trabeculectomy (88 eyes of 88 patients) or bleb needling (12 eyes of 12 patients) with mitomycin C. A significant predictor of hypotony complications was identified from (1) operation (trabeculectomy or bleb needling), (2) age, (3) sex, (4) disease type (primary open-angle glaucoma, exfoliation glaucoma or other), (5) lens status (phakia or pseudophakia), (6) preoperative Goldmann applanation tonometry (GAT) intraocular pressure (IOP), (7) preoperative central corneal thickness (CCT), (8) preoperative axial length (AL), (9) preoperative anterior chamber depth, (10) "Min IOP" (IOP value when hypotony complications occurred, otherwise the minimum IOP during 3 months from trabeculectomy or bleb needling), (11) preoperative corneal curvature, and (12-24) 12 Corvis ST parameters using multivariate logistic regression.

RESULTS

There were 13 and 21 eyes developed hypotony maculopathy and CD, respectively. Male gender, greater preoperative GAT IOP, and greater highest concavity deflection Amplitude were significant predictors of the occurrence of hypotony maculopathy (P < .05). On the other hand, shorter AL, thinner CCT, greater preoperative GAT IOP and pseudophakia were significant predictors of the occurrence of CD (P < .05).

CONCLUSIONS

A careful attention should be paid to the occurrence of hypotony maculopathy with male gender and greater highest concavity deflection Amplitude despite higher preoperative GAT IOP. Different risk factors were identified; shorter AL, thinner CCT, greater preoperative GAT IOP, and pseudophakia.

摘要

目的

本研究旨在探讨使用 Corvis ST 测量生物力学参数在预测青光眼滤过手术后低眼压性黄斑病变和脉络膜脱离(CD)中的作用。

设计

临床队列研究。

方法

本研究纳入了 100 只眼(100 例患者),这些患者均接受了小梁切除术(88 只眼,88 例患者)或小梁切开术(12 只眼,12 例患者)联合丝裂霉素 C 治疗。通过多变量逻辑回归分析,从(1)手术类型(小梁切除术或小梁切开术)、(2)年龄、(3)性别、(4)疾病类型(原发性开角型青光眼、剥脱性青光眼或其他)、(5)晶状体状态(白内障或人工晶状体)、(6)术前眼压(GAT)、(7)术前中央角膜厚度(CCT)、(8)术前眼轴长度(AL)、(9)术前前房深度、(10)“最低眼压”(发生低眼压并发症时的眼压值,否则为小梁切除术或小梁切开术后 3 个月内的最低眼压)、(11)术前角膜曲率和(12-24)12 个 Corvis ST 参数中筛选出了导致低眼压性黄斑病变和 CD 的显著预测因子。

结果

分别有 13 只眼和 21 只眼出现了低眼压性黄斑病变和 CD。男性、较高的术前 GAT 眼压和较高的最大凹陷变形幅度是低眼压性黄斑病变发生的显著预测因子(P <.05)。另一方面,较短的 AL、较薄的 CCT、较高的术前 GAT 眼压和人工晶状体是 CD 发生的显著预测因子(P <.05)。

结论

尽管术前 GAT 眼压较高,但对于男性和较高的最大凹陷变形幅度的患者,应密切关注低眼压性黄斑病变的发生。此外,还确定了不同的危险因素,包括较短的 AL、较薄的 CCT、较高的术前 GAT 眼压和人工晶状体。

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