Aldossari Shaikha H, Schargel Konrad, Aljadaan Ibrahim, Ahmad Khabir, Gorinees Rakan, Alzendi Nouf, Sesma Gorka
Glaucoma Division King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Research Department King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
J Ophthalmol. 2024 Jul 30;2024:7127996. doi: 10.1155/2024/7127996. eCollection 2024.
To assess the association between early postoperative choroidal detachment and intraocular pressure (IOP) following nonpenetrating deep sclerectomy in pediatric primary congenital glaucoma.
Retrospective double-arm cohort study. . Single center in Saudi Arabia. . Seventy-two eyes of 45 patients were evaluated. Primary congenital glaucoma patients aged 0-3 years undergoing nonpenetrating deep sclerectomy as the first procedure from 2014 to 2021 were divided into groups with ( = 20) and without ( = 52) postoperative choroidal detachment. . The primary outcome was complete surgical success, defined as an intraocular pressure below 21 mmHg without medication or additional surgery at 24 months. The intraocular pressure was evaluated in the first 72 hours after surgery and at 1, 3, 6, 12, 18, and 24 months. Kaplan-Meier survival analysis over 24 months was used to evaluate this outcome in both cohorts. The secondary outcome was the time to choroidal detachment resolution.
There was no significant difference in surgical success between choroidal detachment and nonchoroidal detachment groups ( = 0.12). Preoperative and 2-year postoperative intraocular pressure was similar between groups, with a significant decrease in intraocular pressure from baseline ( < 0.001) in both the groups. The median time to choroidal detachment resolution was 27 days, and 90% of choroidal detachment cases were resolved with medical therapy.
Postoperative choroidal detachment does not appear to significantly impact intraocular pressure or surgical success at 24 months following nonpenetrating deep sclerectomy for primary congenital glaucoma. Choroidal detachment typically resolves within one month of treatment. These findings suggest that transient choroidal detachment has a benign course in patients with primary congenital glaucoma undergoing deep sclerectomies.
评估小儿原发性先天性青光眼非穿透性深层巩膜切除术后早期脉络膜脱离与眼压（IOP）之间的关联。
回顾性双臂队列研究。沙特阿拉伯的单中心研究。评估了45例患者的72只眼。2014年至2021年接受非穿透性深层巩膜切除术作为首次手术的0至3岁原发性先天性青光眼患者被分为术后发生脉络膜脱离（n = 20）和未发生脉络膜脱离（n = 52）两组。主要结局为完全手术成功，定义为术后24个月眼压低于21 mmHg且无需药物治疗或额外手术。在术后前72小时以及1、3、6、12、18和24个月评估眼压。采用Kaplan-Meier生存分析评估两组24个月内的这一结局。次要结局为脉络膜脱离消退的时间。
脉络膜脱离组和非脉络膜脱离组在手术成功率方面无显著差异（P = 0.12）。两组术前和术后2年的眼压相似，两组眼压均较基线水平显著降低（P < 0.001）。脉络膜脱离消退的中位时间为27天，90%的脉络膜脱离病例通过药物治疗得以消退。
对于原发性先天性青光眼，非穿透性深层巩膜切除术后24个月，术后脉络膜脱离似乎对眼压或手术成功率无显著影响。脉络膜脱离通常在治疗后1个月内消退。这些发现表明，对于接受深层巩膜切除术的原发性先天性青光眼患者，短暂性脉络膜脱离病程呈良性。
