Chihara Etsuo, Nakano Eri, Chihara Tomoyuki
Sensho-kai Eye Institute, Minamiyama 50-1, Iseda, Kyoto 611-0043, Japan.
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto 611-0043, Japan.
J Clin Med. 2024 Dec 16;13(24):7660. doi: 10.3390/jcm13247660.
The objective of this study was to evaluate the impact of diabetes mellitus (DM) on the outcome of Schlemm's canal-based minimally invasive glaucoma surgery (MIGS). : In a retrospective interventional cohort study, postoperative intraocular pressure (IOP) and intracameral bleeding were analyzed in 25 diabetic patients and 84 non-diabetic patients, with primary open-angle glaucoma (POAG) or ocular hypertension (OH). : The mean follow-up period for all 109 eyes was 35.3 ± 24.8 months. There was no significant difference in preoperative IOP between cohorts with or without diabetes. However, the post-surgical IOP between 3 months and 2 years was significantly higher in the cohort with diabetes ( = 0.019 to 0.001). The 3-year survival probability of achieving an IOP ≤ 15 mmHg was 17.8 ± 0.09% in patients with diabetes, significantly lower than the 30.4 ± 0.06% observed in patients without diabetes ( = 0.042 Log-rank test). The 3-year survival probability of achieving an IOP ≤ 18 mmHg was 56.7 ± 0.12% in patients with diabetes compared to 79.5 ± 0.05% in patients without diabetes, indicating a marginally significant difference between cohorts with and without diabetes ( = 0.065). When the random effect of diabetes mellitus (DM) was analyzed alongside the fixed effects of preoperative IOP, age, refractive error, and the extent of canal opening using a multivariate linear mixed model, DM emerged as a significant risk factor for higher postoperative IOP at both 6 and 12 months ( < 0.001). : Diabetes mellitus is a significant risk factor for poor outcomes following Schlemm's canal-based MIGS, particularly in achieving lower postoperative IOP.
本研究的目的是评估糖尿病（DM）对基于施莱姆管的微创青光眼手术（MIGS）预后的影响。在一项回顾性干预队列研究中，分析了25例糖尿病患者和84例非糖尿病患者的术后眼压（IOP）和前房内出血情况，这些患者均患有原发性开角型青光眼（POAG）或高眼压症（OH）。所有109只眼睛的平均随访期为35.3±24.8个月。糖尿病组和非糖尿病组术前眼压无显著差异。然而，糖尿病组术后3个月至2年的眼压显著更高（P = 0.019至0.001）。糖尿病患者眼压≤15 mmHg的3年生存概率为17.8±0.09%，显著低于非糖尿病患者观察到的30.4±0.06%（P = 0.042，对数秩检验）。糖尿病患者眼压≤18 mmHg的3年生存概率为56.7±0.12%，而非糖尿病患者为79.5±0.05%，表明糖尿病组和非糖尿病组之间存在边缘显著差异（P = 0.065）。当使用多变量线性混合模型分析糖尿病（DM）的随机效应以及术前眼压、年龄、屈光不正和管开口程度的固定效应时，DM成为术后6个月和12个月眼压升高的显著危险因素（P < 0.001）。糖尿病是基于施莱姆管的MIGS术后预后不良的重要危险因素，尤其是在实现较低的术后眼压方面。
