Harano Akiko, Ichioka Sho, Murakami Kana, Iida Mizuki, Tanito Masaki
Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan.
J Clin Med. 2024 Dec 25;14(1):42. doi: 10.3390/jcm14010042.
: To report the role of prostaglandin-associated periorbitopathy (PAP) severity on the surgical efficacy of Ahmed Glaucoma Valve (AGV) implantation. : Retrospective observational case series. Participants were the consecutive 102 eyes from 102 Japanese subjects (55 males, 47 females; mean age ± standard deviation, 74.9 ± 7.8 years) who underwent AGV implantation for primary open-angle glaucoma (POAG), completed full postoperative visits for 12 months, and had information on PAP severity graded by the Shimane University PAP Grading System (SU-PAP). Data were collected via medical chart review. Comparison of surgical success rates among groups stratified by SU-PAP grades (grades 0-3) using survival curve analysis. Failure was defined based on additional glaucoma surgery, IOP reduction in less than 20%, postoperative IOP exceeding 18 mmHg (definition A) or 15 mmHg (definition B), or postoperative visual acuity reduced to no light perception. : At 12 months postoperatively, the success rates for grades 0, 1, 2, and 3 were 47%, 43%, 42%, and 73%, respectively, for definition A ( = 0.35) and 35%, 26%, 19%, and 27%, respectively, for definition B ( = 0.64, log-rank test). For definition A, younger age was associated with surgical failure (Hazard ratio = 0.97/year, = 0.049, Wald test), while no other factors, including gender, preoperative IOP, medications, refractive error, history of conjunctival manipulation procedures, or SU-PAP grade, were associated with surgical failure. For definition B, no factors were found to influence surgical outcomes. : The preoperative severity of PAP might not affect the postoperative outcomes of AGV. Given that the success rate of trabeculectomy is influenced by PAP severity, in cases with severe PAP, physicians are advised to consider long-tube shunt surgery as an initial filtration procedure or as a rescue procedure when filtration surgery is unsuccessful.
报告前列腺素相关性眶周病变（PAP）严重程度对艾哈迈德青光眼引流阀（AGV）植入术手术疗效的影响。：回顾性观察病例系列。研究对象为102名日本受试者（55名男性，47名女性；平均年龄±标准差，74.9±7.8岁）的102只连续眼睛，这些受试者因原发性开角型青光眼（POAG）接受了AGV植入术，术后完成了12个月的全面随访，并掌握了由岛根大学PAP分级系统（SU-PAP）分级的PAP严重程度信息。通过病历审查收集数据。采用生存曲线分析比较按SU-PAP分级（0 - 3级）分层的各组手术成功率。失败的定义基于额外的青光眼手术、眼压降低不足20%、术后眼压超过18 mmHg（定义A）或15 mmHg（定义B），或术后视力降至无光感。：术后12个月，对于定义A（= 0.35），0级、1级、2级和3级的成功率分别为47%、43%、42%和73%，对于定义B（= 0.64，对数秩检验），分别为35%、26%、19%和27%。对于定义A，年龄较小与手术失败相关（风险比 = 0.97/年，= 0.049，Wald检验），而包括性别、术前眼压、用药情况、屈光不正、结膜手术史或SU-PAP分级在内的其他因素均与手术失败无关。对于定义B，未发现有因素影响手术结果。：PAP的术前严重程度可能不会影响AGV的术后结果。鉴于小梁切除术的成功率受PAP严重程度影响，在PAP严重的病例中，建议医生将长管分流手术作为初始滤过手术或滤过手术失败时的挽救手术。
