Department of Ophthalmology, Yeungnam University College of Medicine, Yeungnam University Hospital, Daegu, Korea.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Sci Rep. 2024 Nov 16;14(1):28341. doi: 10.1038/s41598-024-79637-z.
This retrospective study evaluated the association between preoperative topical glaucoma medication containing preservatives and long-term trabeculectomy outcomes in 309 eyes from 201 patients with primary open-angle glaucoma, followed for over 10 years. The Glaucoma Medication Intensity Index (GMII) was calculated to quantify the cumulative preoperative exposure to these medications. Kaplan-Meier analysis revealed cumulative success rates of 89.3%, 59.2%, and 46% at 1, 10, and 20 years postoperatively. At 20 years, the success group had a significantly lower GMII (3.28 vs. 8.74, p = 0.004). A GMII threshold of ≥ 4.35 was associated with poorer long-term intraocular pressure (IOP) control and shorter surgical success duration. Cox regression analysis identified advanced age at surgery, higher GMII, and subsequent cataract surgery as significant risk factors for trabeculectomy failure. These findings underscore the adverse impact of prolonged preoperative use of glaucoma medications on long-term surgical outcomes, highlighting GMII as a valuable predictor for guiding preoperative management strategies.
本回顾性研究评估了 201 例原发性开角型青光眼患者的 309 只眼，这些患者术前使用含有防腐剂的局部降眼压药物，随访时间超过 10 年。计算了青光眼药物强度指数（Glaucoma Medication Intensity Index，GMII）来量化这些药物的术前累积暴露量。Kaplan-Meier 分析显示，术后 1、10 和 20 年的累积成功率分别为 89.3%、59.2%和 46%。20 年后，成功组的 GMII 明显更低（3.28 对 8.74，p=0.004）。GMII 阈值≥4.35 与较差的长期眼压（IOP）控制和较短的手术成功持续时间相关。Cox 回归分析确定手术时年龄较大、GMII 较高和随后的白内障手术是小梁切除术失败的显著危险因素。这些发现强调了术前长期使用降眼压药物对长期手术结果的不利影响，凸显了 GMII 作为指导术前管理策略的有价值的预测指标。
