5-0普理灵缝线在印度青光眼患者眼中行房角镜辅助小梁切开联合超声乳化白内障吸除术的早期疗效
Early outcomes of 5-0 Prolene gonioscopy-assisted transluminal trabeculotomy combined with phacoemulsification in eyes of Indian glaucoma patients.
作者信息
Maheshwari Devendra, Pillai Madhavi Ramanatha, Nagdev Nimrita Gyanchand, Gupta Shivam, Ramakrishnan Rengappa, Kader Mohideen Abdul, Uduman Mohammed Sithiq
机构信息
Department of Glaucoma, Aravind Eye Hospital and PG Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
Department of Biostatistician, Aravind Eye Hospital and PG Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
出版信息
Indian J Ophthalmol. 2025 Mar 1;73(Suppl 2):S287-S292. doi: 10.4103/IJO.IJO_3065_23. Epub 2024 Aug 14.
PURPOSE
To study the early postoperative efficacy and safety of 5-0 Prolene gonioscopy-assisted transluminal trabeculotomy (GATT) combined with phacoemulsification in Indian eyes.
METHODS
This was a prospective, interventional study. Patients with primary and secondary glaucoma who underwent GATT combined with phacoemulsification (Phaco-GATT) or standalone GATT were included. All patients were evaluated on postoperative days 1, 15, and 30, as well as 3 months and 6 months postoperatively. Baseline and follow-up visits were compared to determine the significant difference in the number of intraocular pressure (IOP), antiglaucoma medications (AGM), and best corrected visual acuity (BCVA). Other outcome measures included surgical success, complications, and interventions. A P value of < 0.05 was considered statistically significant.
RESULTS
One hundred and five eyes (95 patients) were included. Seventy-five eyes underwent GATT along with phacoemulsification and 30 eyes underwent GATT. In the Phaco-GATT group, the mean IOP reduced significantly from 17.71 ± 6.85 to 12.29 ± 4.44, 12.33 ± 4.44, and 12.18 ± 3.49 mmHg and in the GATT group, it reduced from 21.67 ± 11.42 mmHg to 16.38 ± 8.42, 16.47 ± 10.26, and 13.10 ± 3.25 mmHg at 1, 3, and 6 months, respectively ( P < 0.001). The number of AGM also significantly reduced from 1.67 ± 1.22 to 0.41 ± 0.87 and 0.34 ± 0.82 in the phaco-GATT group and from 2.63 ± 1.19 to 0.67 ± 1.09 and 0.60 ± 1.25 in the GATT group at 3 and 6 months, respectively ( P < 0.001). Complete success (IOP > 6-≤21 mmHg/20% reduction without AGM) was 96.7% in the Phaco-GATT group and 91.2% in the GATT group. BCVA improved from log of minimum angle of resolution 0.30 to 0.00 ( P < 0.001) in phaco-GATT group. Hyphema was the most common complication. Macrohyphema (>1 mm) was seen in six patients, out of which two patients required anterior chamber wash. IOP spikes (>30 mmHg) were seen in three patients.
CONCLUSION
In Indian eyes, GATT combined with phacoemulsification and standalone GATT are efficacious and safe with good surgical outcomes.
目的
研究5-0普理灵前房角镜辅助小梁切开术（GATT）联合白内障超声乳化术在印度患者眼中的术后早期疗效及安全性。
方法
这是一项前瞻性干预性研究。纳入接受GATT联合白内障超声乳化术（Phaco-GATT）或单纯GATT的原发性和继发性青光眼患者。所有患者在术后第1天、15天、30天以及术后3个月和6个月进行评估。比较基线和随访情况，以确定眼内压（IOP）、抗青光眼药物（AGM）数量和最佳矫正视力（BCVA）的显著差异。其他观察指标包括手术成功率、并发症和干预措施。P值<0.05被认为具有统计学意义。
结果
共纳入105只眼（95例患者）。75只眼接受了GATT联合白内障超声乳化术，30只眼接受了单纯GATT。在Phaco-GATT组，平均IOP在术后1个月、3个月和6个月时分别从17.71±6.85显著降至12.29±4.44、12.33±4.44和12.18±3.49 mmHg；在GATT组，分别从21.67±11.42 mmHg降至16.38±8.42、16.47±10.26和13.10±3.25 mmHg（P<0.001）。Phaco-GATT组AGM数量在术后3个月和6个月时也分别从1.67±1.22显著降至0.41±0.87和0.34±0.82；GATT组分别从2.63±1.19降至0.67±1.09和0.60±1.25（P<0.001）。Phaco-GATT组完全成功率（IOP>6-≤21 mmHg/无需AGM且降低20%）为96.7%，GATT组为91.2%。Phaco-GATT组BCVA从最小分辨角对数0.30提高到0.00（P<0.001）。前房积血是最常见的并发症。6例患者出现大量前房积血（>1 mm），其中2例患者需要进行前房冲洗。3例患者出现IOP峰值（>30 mmHg）。
结论
在印度患者眼中，GATT联合白内障超声乳化术和单纯GATT有效且安全，手术效果良好。
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