Iwasaki Kentaro, Arimura Shogo, Takamura Yoshihiro, Inatani Masaru
Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan.
J Clin Med. 2025 Mar 17;14(6):2039. doi: 10.3390/jcm14062039.
This study evaluated the clinical preferences of glaucoma specialists regarding glaucoma surgery and postoperative management in Japan in 2024. A survey about clinical practice preferences regarding glaucoma surgery and postoperative care was administered among 50 glaucoma specialists who were councilors in the Japan Glaucoma Society. Minimally invasive glaucoma surgery (MIGS) plus phacoemulsification was the most preferred procedure for nonoperated mild to moderate cases of primary open-angle glaucoma (POAG) (94.6%) and normal tension glaucoma (NTG) (67.3%) associated with cataract. Microhook surgery was the most preferred among the MIGS procedures. Meanwhile, PreserFlo MicroShunt (PMS) surgery is emerging as a popular option for cases of POAG and NTG, especially in advanced-stage pseudophakic eyes that underwent prior corneal incision phacoemulsification (40.1%). Long-tube shunt surgeries were predominantly preferred for POAG after two failed trabeculectomies (69.4%) and for neovascular glaucoma with prior vitrectomy after a failed trabeculectomy (73.0%). Among long-tube shunt surgeries, the Ahmed glaucoma valve (AGV) was preferred over the Baerveldt glaucoma implant. Trabeculectomy required the most frequent follow-up visits within the first postoperative year, whereas PMS and long-tube shunt surgeries required comparatively fewer follow-up visits. Overall, MIGS involved less frequent follow-up visits versus filtering surgeries. MIGS is currently the procedure of choice for primary glaucoma surgery in Japan. Among glaucoma specialists of the Japan Glaucoma Society, PMS surgery is becoming popular for cases of POAG and NTG. Refractory glaucoma is commonly treated with long-tube shunt surgeries, especially the AGV.
本研究评估了2024年日本青光眼专家在青光眼手术及术后管理方面的临床偏好。对日本青光眼协会顾问中的50位青光眼专家进行了一项关于青光眼手术及术后护理临床实践偏好的调查。对于未手术的轻度至中度原发性开角型青光眼（POAG）（94.6%）和与白内障相关的正常眼压性青光眼（NTG）（67.3%）病例，微创青光眼手术（MIGS）联合超声乳化术是最受青睐的术式。在MIGS术式中，微钩手术最受青睐。同时，PreserFlo微分流器（PMS）手术正成为POAG和NTG病例的热门选择，尤其是在先前接受过角膜切口超声乳化术的晚期人工晶状体眼（40.1%）。对于小梁切除术失败后的POAG（69.4%）以及小梁切除术失败后先前接受过玻璃体切除术的新生血管性青光眼（73.0%）病例，长管分流手术是主要的首选术式。在长管分流手术中，艾哈迈德青光眼阀（AGV）比贝尔维尔德青光眼植入物更受青睐。小梁切除术在术后第一年需要最频繁的随访，而PMS和长管分流手术需要的随访相对较少。总体而言，与滤过性手术相比，MIGS的随访频率较低。目前，MIGS是日本原发性青光眼手术的首选术式。在日本青光眼协会的青光眼专家中，PMS手术在POAG和NTG病例中越来越受欢迎。难治性青光眼通常采用长管分流手术治疗，尤其是AGV。
