Department of Ophthalmology and Visual Science, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
Sci Rep. 2024 Sep 17;14(1):21725. doi: 10.1038/s41598-024-72715-2.
To investigate ciliochoroidal detachment (CCD) frequency and risk factors after performing goniotomy with the Kahook Dual Blade (KDB). The presence of CCD was examined using anterior-segment optical coherence tomography at postoperative day (POD) 1, month 1, and month 2 in 91 eyes of patients who underwent goniotomy with KDB. Intraocular pressure (IOP) was also measured at POD 1, POD 7, month 1 and month 2. A generalized linear mixed model analysis was used to compare the age, gender, axial length, central corneal thickness, surgical procedure (combined or single), operators (K.H. or H.O.), glaucoma type and preoperative IOP between the groups. Factors were selected from the variants when there was a probability value of less than 0.05. CCD was detected in 18 eyes (19.7%) at POD 1. For postoperative IOP, no significant differences were observed between the CCD and non-CCD groups. However, the IOP on POD 1 in the CCD that was associated with the anterior chamber group (7.7 ± 3.0 mmHg) was significantly lower than that in the non-CCD group (15.3 ± 0.9 mmHg) (P = 0.02). Mixed-effects model analysis demonstrated that the surgical procedure (combined) and operator (H.O.) were significantly associated with the higher incidence of CCD. Approximately one-fifth of all eyes exhibited CCD after goniotomy with KDB. Combining cataract surgery and goniotomy with KDB and the intraoperative procedure during the goniotomy with KDB were all found to be risk factors for developing CCD.
探讨用 Kahook 双切刀（KDB）行房角切开术后睫状体脉络膜脱离（CCD）的发生频率和相关危险因素。
对 91 例行 KDB 房角切开术的患者，分别于术后第 1 天、第 1 个月和第 2 个月使用眼前节光学相干断层扫描（OCT）检查 CCD 的发生情况，同时在术后第 1 天、第 7 天、第 1 个月和第 2 个月测量眼压（IOP）。采用广义线性混合模型分析比较各组间年龄、性别、眼轴长度、中央角膜厚度、手术方式（联合或单纯）、术者（K.H.或 H.O.）、青光眼类型和术前 IOP 的差异。当概率值小于 0.05 时，从变异中选择因素。术后第 1 天，18 只眼（19.7%）出现 CCD。术后 IOP 方面，CCD 组和无 CCD 组之间无显著差异。然而，与前房相关的 CCD 组（7.7 ± 3.0mmHg）术后第 1 天的 IOP 明显低于无 CCD 组（15.3 ± 0.9mmHg）（P = 0.02）。混合效应模型分析表明，手术方式（联合）和术者（H.O.）与 CCD 发生率升高显著相关。约五分之一的眼在 KDB 房角切开术后出现 CCD。白内障联合 KDB 房角切开术和术中 KDB 房角切开术均为发生 CCD 的危险因素。
