Pereira I Eduardo Akio, Gomide Vilela de S Franco Cláudia, Alves Pereira Ana Cláudia, Teno Bruno, Lucena-Neto Francisco, M Faria Bruno, Maggi Vieira Júlia, Pereira Vianello Marcos, N Kanadani Fábio, Magacho Leopoldo
Department of Ophthalmology, Federal University of Goiás, Goiânia, 74605-020, Brazil.
Hospital de Olhos de Palmas, Palmas, 77021-622, Brazil.
Sci Rep. 2024 Dec 28;14(1):30934. doi: 10.1038/s41598-024-81837-6.
This retrospective, comparative, multicenter study aimed to evaluate the real-world outcomes and predictors of failure of Gonioscopy-assisted transluminal trabeculotomy (GATT) at 12 months in glaucoma patients. Predictors of failure of absolute success in bilateral cases (422 eyes of 308 patients) included pre-operative intraocular pressure (IOP; IRR = 1.02; p = 0.01), and pre-operative mean deviation (IRR = 0.98; p = 0.007). The significant predictors of failure of relative success included binocularity (IRR = 4.05; p = 0.001) and pre-operative IOP (IRR = 1.04; p = 0.022). Only one eye per patient (308 eyes) was included in the second analysis. IOP reduced from 21.84 ± 7.96 mmHg to 11.97 ± 2.89 mmHg at 12 months; the number of hypotensive eye drop medications decreased from 3.07 ± 1.04 to 1.06 ± 1.08 (p < 0.001 for both). The pre-operative IOP was a predictive factor for failure of absolute (IRR = 1.02; p = 0.026) and relative successes (IRR = 1.05; p = 0.014). The preoperative number of hypotensive medications only affected absolute success (IRR = 1.25; p = 0.004). The Kaplan-Meier graph revealed relative and absolute success in 88.9% and 43.9% of cases, respectively. In conclusion, GATT is a safe and effective treatment option for diverse forms of open-angle glaucoma with varying severity. Pre-operative number of medications and IOP, race, and the outcomes of the contralateral eye (if applicable) were identified as predictors of failure of the procedure.
这项回顾性、对比性、多中心研究旨在评估青光眼患者在12个月时房角镜辅助小梁切开术（GATT）的实际疗效及手术失败的预测因素。双侧病例（308例患者的422只眼）绝对成功失败的预测因素包括术前眼压（IOP；风险比[IRR]=1.02；p=0.01）和术前平均偏差（IRR=0.98；p=0.007）。相对成功失败的显著预测因素包括双眼情况（IRR=4.05；p=0.001）和术前眼压（IRR=1.04；p=0.022）。第二次分析仅纳入每位患者的一只眼（308只眼）。12个月时眼压从21.84±7.96 mmHg降至11.97±2.89 mmHg；降压眼药水的使用数量从3.07±1.04降至1.06±1.08（两者p均<0.001）。术前眼压是绝对成功失败（IRR=1.02；p=0.026）和相对成功失败（IRR=1.05；p=0.014）的预测因素。术前降压药物的使用数量仅影响绝对成功（IRR=1.25；p=0.004）。Kaplan-Meier曲线显示，相对成功和绝对成功的病例分别为88.9%和43.9%。总之，GATT是治疗不同严重程度各种开角型青光眼的一种安全有效的治疗选择。术前药物使用数量、眼压、种族以及对侧眼的情况（如适用）被确定为该手术失败的预测因素。
