Shih En-Jie, Chen Ying-Ying
Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
Sci Rep. 2025 Feb 27;15(1):6992. doi: 10.1038/s41598-025-86650-3.
This study introduced a modified trabeculectomy method and compare its effectiveness and safety to prior studies. Twenty-seven glaucoma patients (32 eyes) underwent mitomycin C-augmented trabeculectomy with a unique scleral flap shape at Kaohsiung Veterans General Hospital. The IOP decreased significantly from baseline (28.80 ± 11.37 mm Hg) to postoperative day 1, week 1, week 2, week 4, week 6, month 3, month 6, and year 1 (range, 14.10 ± 5.90 to 17.80 ± 5.14 mm Hg; all p < 0.05). The antiglaucoma medication use also decreased significantly from baseline (n = 4.72 ± 1.25) to 1 year after trabeculectomy (n = 0.75 ± 1.37) (p < 0.001). No surgical failures or glaucoma reoperations occurred during follow-up. Early complications and interventions included bleb encapsulation (n = 3, 9.38%), bleb leaks (n = 3, 9.38%), and needling revision (n = 1, 3.13%). Late complications and interventions included bleb encapsulation (n = 2, 6.45%), needling (n = 5, 16.13%), and cataract extraction (n = 2, 6.45%). Our trabeculectomy method with a modified scleral flap shape has demonstrated comparable success rates and improved safety compared to existing techniques. However, as this is a retrospective study, further randomized controlled trials are needed to draw definitive conclusions regarding its superiority or comparability.
本研究介绍了一种改良小梁切除术方法，并将其有效性和安全性与先前的研究进行比较。27例青光眼患者（32只眼）在高雄荣民总医院接受了丝裂霉素C辅助小梁切除术，采用独特的巩膜瓣形状。眼压从基线（28.80±11.37 mmHg）显著下降至术后第1天、第1周、第2周、第4周、第6周、第3个月、第6个月和第1年（范围为14.10±5.90至17.80±5.14 mmHg；所有p<0.05）。抗青光眼药物的使用也从基线（n=4.72±1.25）显著下降至小梁切除术后1年（n=0.75±1.37）（p<0.001）。随访期间未发生手术失败或青光眼再次手术。早期并发症及干预包括滤过泡包裹（n=3，9.38%）、滤过泡渗漏（n=3，9.38%）和针刺修复（n=1，3.13%）。晚期并发症及干预包括滤过泡包裹（n=2，6.45%）、针刺（n=5，16.13%）和白内障摘除（n=2，6.45%）。与现有技术相比，我们改良巩膜瓣形状的小梁切除术方法显示出相当的成功率和更高的安全性。然而，由于这是一项回顾性研究，需要进一步的随机对照试验来得出关于其优越性或可比性的确切结论。
