开角型青光眼患者中，使用或不使用ABiC的GATT的比较有效性和安全性。
Comparative effectiveness and safety of GATT with or without ABiC in patients with open-angle glaucoma.
作者信息
Zhang Weijia, Wang Yiwei, Chen Xin, Zhang Ke, Yang Zhen, Sang Jinghong, Zhang Chun, Wang Huaizhou
机构信息
Department of Ophthalmology, Peking University Third Hospital, Beijing, China.
Department of Ophthalmology, Henan Provincial People's Hospital, Zhengzhou, China.
出版信息
Front Med (Lausanne). 2025 Aug 26;12:1581608. doi: 10.3389/fmed.2025.1581608. eCollection 2025.
BACKGROUND
This is the first comprehensive comparison between gonioscopy-assisted transluminal trabeculotomy (GATT) and GATT combined with ab interno canaloplasty (ABiC) in patients with OAG.
PURPOSE
The purpose of this study was to compare the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) combined with ab interno canaloplasty (ABiC) with those of GATT alone in patients with open-angle glaucoma (OAG).
DESIGN
This was a retrospective, comparative case series.
PARTICIPANTS
Patients with primary open angle glaucoma who underwent GATT (27 eyes in Group 1) or GATT + ABiC (26 eyes in Group 2) were included.
METHODS
Outcomes including intraocular pressure (IOP), glaucoma medications, and surgical complications were analyzed.
MAIN OUTCOME MEASURES
Surgical success was defined in terms of IOP and medication use as follows: (1) a preoperative IOP > 21 mmHg and a postoperative IOP ≤ 21 mmHg with at least a 20% reduction from baseline with (qualified success) or without (complete success) glaucoma medications or (2) a preoperative IOP < 21 mmHg while taking 3 or more glaucoma medications and a postoperative IOP ≤ 21 mmHg with a reduction of more than two medications (qualified success) or with no medications (complete success).
RESULTS
At 12 months, the mean IOP was 14.8 ± 2.2 mmHg in Group 1 and 16.6 ± 2.3 mmHg in Group 2 ( = 0.008). The number of medications was 0.6 ± 1.0 in Group 1 and 0.9 ± 1.3 in Group 2 ( = 0.334). At 24 months, the mean IOP was 15.3 ± 2.0 mmHg in Group 1 and 15.5 ± 2.4 mmHg in Group 2 ( = 0.676). The number of medications was 0.5 ± 0.9 in Group 1 and 0.9 ± 1.1 in Group 2 ( = 0.197). The complete success rates were 63.0% in Group 1 and 50.0% in Group 2 ( = 0.16), and the qualified success rates were 81.5% in Group 1 and 76.9% in Group 2 ( = 0.51).
CONCLUSION
The GATT procedure, with or without ABiC, is safe and effective in decreasing the IOP and the number of antiglaucoma medications used.
背景
这是首次对开角型青光眼（OAG）患者进行房角镜辅助小梁切开术（GATT）与GATT联合内路小梁成形术（ABiC）的全面比较。
目的
本研究旨在比较房角镜辅助小梁切开术（GATT）联合内路小梁成形术（ABiC）与单纯GATT治疗开角型青光眼（OAG）患者的疗效和安全性。
设计
这是一项回顾性比较病例系列研究。
研究对象
纳入接受GATT（第1组27只眼）或GATT + ABiC（第2组26只眼）的原发性开角型青光眼患者。
方法
分析包括眼压（IOP）、青光眼药物使用情况及手术并发症等结果。
主要观察指标
手术成功根据眼压和药物使用情况定义如下：（1）术前眼压>21 mmHg且术后眼压≤21 mmHg，使用（合格成功）或未使用（完全成功）青光眼药物时眼压较基线至少降低20%；或（2）术前眼压<21 mmHg且使用3种或更多青光眼药物，术后眼压≤21 mmHg且药物减少超过2种（合格成功）或未使用药物（完全成功）。
结果
12个月时，第1组平均眼压为14.8±2.2 mmHg，第2组为16.6±2.3 mmHg（P = 0.008）。第1组药物数量为0.6±1.0，第2组为0.9±1.3（P = 0.334）。24个月时，第1组平均眼压为15.3±2.0 mmHg，第2组为15.5±2.4 mmHg（P = 0.676）。第1组药物数量为0.5±0.9，第2组为0.9±1.1（P = 0.197）。第1组完全成功率为63.0%，第2组为50.0%（P = 0.16），第1组合格成功率为81.5%，第2组为76.9%（P = 0.51）。
结论
无论是否联合ABiC，GATT手术在降低眼压和减少抗青光眼药物使用数量方面都是安全有效的。
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