Levinger Eliya, Ostrovsky Michael, Friehmann Asaf, Elhaddad Omar, Tole Derek, Darcy Kieren, Leadbetter Duncan, Tuuminen Raimo, Goldberg Mordechai, Achiron Asaf
Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Acta Ophthalmol. 2025 Feb;103(1):115-120. doi: 10.1111/aos.16766. Epub 2024 Oct 11.
To assess the risk for pseudophakic cystoid macular oedema (PCME) and posterior capsular opacification (PCO) associated with combined cataract surgery and trabeculectomy compared to cataract surgery alone.
Data analysis of subjects who underwent routine cataract surgery without and with concomitant trabeculectomy at the Department of Ophthalmology, Bristol Eye Hospital, the UK, between January 2008 and December 2017. Odds ratios (ORs) for PCME between the types of surgeries were calculated using univariate and multivariate regression analysis. Multivariate Cox regression controlling for age and gender was used to estimate the hazard ratio (HR) for neodymium-doped yttrium aluminium garnet (Nd:YAG) laser capsulotomies.
This study included 56 973 cataract surgeries without and 288 with concomitant trabeculectomy (phaco-trab) with a mean follow-up time of 6.9 ± 4.2 years. Baseline variables (age and gender, diabetes, pseudoexfoliation, use of pupil expansion device and postoperative follow-up time) were comparable between the groups. Postoperative rates of PCME remained non-significant between the cataract surgery and phaco-trabe groups both in uni- and multi-variate analysis (OR 0.347, 95%CI 0.049-2.477, p = 0.291). Furthermore, in Cox regression analysis adjusted for the patients' age and gender, Nd:YAG laser capsulotomy rates remained non-significant between the cataract surgery and phaco-trabe groups (HR 1.250, 95%CI 0.883-1.769, p = 0.209).
In our large cohort study, combining trabeculectomy with cataract surgery did not predispose to an increased PCME or Nd:YAG laser capsulotomy rates.
评估与单纯白内障手术相比，白内障手术联合小梁切除术相关的人工晶状体眼黄斑囊样水肿（PCME）和后囊膜混浊（PCO）的风险。
对2008年1月至2017年12月期间在英国布里斯托尔眼科医院眼科接受常规白内障手术（有无小梁切除术）的受试者进行数据分析。使用单因素和多因素回归分析计算手术类型之间PCME的比值比（OR）。采用控制年龄和性别的多因素Cox回归分析来估计钕掺杂钇铝石榴石（Nd:YAG）激光晶状体切开术的风险比（HR）。
本研究纳入了56973例未联合小梁切除术的白内障手术和288例联合小梁切除术（超声乳化-小梁切除术）的白内障手术，平均随访时间为6.9±4.2年。两组之间的基线变量（年龄、性别、糖尿病、假性剥脱、瞳孔扩张装置的使用和术后随访时间）具有可比性。在单因素和多因素分析中，白内障手术组和超声乳化-小梁切除术组之间PCME的术后发生率均无显著差异（OR 0.347，95%CI 0.049-2.477，p = 0.291）。此外，在对患者年龄和性别进行校正的Cox回归分析中，白内障手术组和超声乳化-小梁切除术组之间Nd:YAG激光晶状体切开术的发生率也无显著差异（HR 1.250，95%CI 0.883-1.769，p = 0.209）。
在我们的大型队列研究中，小梁切除术与白内障手术联合进行并不会增加PCME或Nd:YAG激光晶状体切开术的发生率。
