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前房角后退性青光眼患者的前房角镜辅助经腔小梁切开术

Gonioscopy-Assisted Transluminal Trabeculotomy in Patients With Angle Recession Glaucoma.

作者信息

Mirza Enver, Mirza Gunsu D

机构信息

Department of Ophthalmology, Faculty of Medicine, Necmettin Erbakan University.

Beyhekim Training and Research Hospital, Clinic of Ophthalmology, University of Health Sciences, Konya, Turkey.

出版信息

J Glaucoma. 2025 Jul 1;34(7):535-540. doi: 10.1097/IJG.0000000000002568. Epub 2025 Mar 18.

Abstract

PRCIS

Gonioscopy-assisted transluminal trabeculotomy (GATT) is a successful minimally invasive glaucoma surgery (MIGS) technique for treating patients with angle recession glaucoma (ARG).

PURPOSE

To share 1-year follow-up outcomes of GATT in patients with ARG.

PATIENTS AND METHODS

Six eyes of 6 patients with ARG were reviewed in this retrospective study. All of the patients had uncontrolled intraocular pressure (IOP) with antiglaucoma medications (AGM) and a history of blunt ocular trauma (BOT). Preoperative IOP; the number of preoperative AGM; postoperative IOP at first month, third, sixth, and 12th months; postoperative IOP spikes, the need for postoperative AGM, and the need for further surgical interventions were recorded.

RESULTS

Five patients underwent GATT and 1 patient underwent GATT combined with phacoemulsification. IOP decreased from 30.30 [7.20] mm Hg preoperatively to 11.95 [3.45] mm Hg postoperatively at the 12th month (P=0.028), with a median difference of -19.50 mm Hg (95% CI: -25.10 to -14.55). After GATT, all patients had varying degrees of hyphema that did not require surgical intervention. IOP peaks were observed in the postoperative first month in 3 patients and IOP was controlled with AGM in these patients. The median (IQR) preoperative number of AGM decreased significantly compared with the median (IQR) postoperative number of AGM at the 12th month [P=0.038, 4.00 (0.25) vs. 2.00 (1.25), median difference: -1.50, 95% CI: -2.00 to -0.50]. During the 1-year follow-up, no patients with ARG required additional surgical intervention.

CONCLUSION

Due to its low complication rates and successful IOP-lowering effect, we recommended that GATT is an effective, safe, and considerable MIGS procedure for patients with ARG.

摘要

目的

分享房角镜辅助经腔小梁切开术(GATT)治疗房角后退性青光眼(ARG)患者的1年随访结果。

患者与方法

本回顾性研究纳入了6例ARG患者的6只眼。所有患者使用抗青光眼药物(AGM)后眼压控制不佳,且有钝性眼外伤(BOT)史。记录术前眼压、术前AGM数量、术后第1个月、第3个月、第6个月和第12个月的眼压、术后眼压峰值、术后使用AGM的必要性以及进一步手术干预的必要性。

结果

5例患者接受了GATT,1例患者接受了GATT联合超声乳化术。眼压从术前的30.30[7.20]mmHg降至术后第12个月的11.95[3.45]mmHg(P = 0.028),中位数差异为-19.50mmHg(95%CI:-25.10至-14.55)。GATT术后,所有患者均出现不同程度的前房积血,但无需手术干预。3例患者在术后第1个月出现眼压峰值,这些患者的眼压通过AGM得到控制。与术后第12个月AGM的中位数(IQR)相比,术前AGM的中位数(IQR)显著降低[P = 0.038,4.00(0.25)对2.00(1.25),中位数差异:-1.50,95%CI:-2.00至-0.50]。在1年的随访期间,没有ARG患者需要额外的手术干预。

结论

由于其低并发症发生率和成功的降眼压效果,我们建议GATT是一种治疗ARG患者有效、安全且值得考虑的微创青光眼手术(MIGS)方法。

精准性房角镜辅助经腔小梁切开术(GATT)是一种成功的微创青光眼手术(MIGS)技术用于治疗房角后退性青光眼(ARG)患者。

目的

分享GATT治疗ARG患者的1年随访结果。

患者与方法

本回顾性研究纳入6例ARG患者的6只眼。所有患者使用抗青光眼药物(AGM)后眼压控制不佳且有钝性眼外伤(BOT)史。记录术前眼压、术前AGM数量、术后第1个月、第3个月、第6个月和第12个月的眼压、术后眼压峰值、术后使用AGM的必要性以及进一步手术干预的必要性。

结果

5例患者接受GATT,1例患者接受GATT联合超声乳化术。眼压从术前的30.30[7.20]mmHg降至术后第12个月的11.95[3.45]mmHg(P = 0.028),中位数差异为-1(此处原文有误,应为-19.50).50mmHg(95%CI:-25.10至-14.55)。GATT术后所有患者均出现不同程度前房积血但无需手术干预。3例患者术后第1个月出现眼压峰值,这些患者眼压通过AGM控制。与术后第12个月AGM的中位数(IQR)相比术前AGM的中位数(IQR)显著降低[P = 0.038,4.00(0.25)对2.00(1.25),中位数差异:-1.50,95%CI:-2.00至-0.50]。1年随访期间没有ARG患者需要额外手术干预。

结论

由于其低并发症发生率和成功降眼压效果我们建议GATT是治疗ARG患者有效、安全且值得考虑的微创青光眼手术(MIGS)方法。

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