Downes S M, Mission G P, Jones H S, O'Neill E C
Birmingham and Midland Eye Hospital, UK.
Eye (Lond). 1994;8 ( Pt 4):394-7. doi: 10.1038/eye.1994.93.
The value of post-operative intraocular pressure (IOP) in predicting the outcome of trabeculectomy was investigated in a retrospective study of single eyes of 203 Caucasian patients with uncomplicated chronic open angle glaucoma from the Birmingham and Midland Eye Hospital. Post-operative IOPs were recorded on day 1, at 2 weeks, and at 3, 6, 12 and 24 months. Surgical failure, defined as an IOP of 21 mmHg or above throughout the study period, occurred in 66 eyes by 24 months (32.5% failure). Discriminant analysis for the first day post-operative IOP showed a reliability of prediction of success (RPS) and failure (RPF) of 76.4% and 74.4% respectively, with an accuracy of prediction of success (APS) and failure (APF) of 92.6% and 42.6%. At 2 weeks, APS remained high (90.3%) and APF increased with time (63.2%). Certainty of success prediction at any stage is high and certainty of failure prediction becomes greater with time. In terms of IOP on the first post-operative day, 92.6% of successes may be correctly predicted if the IOP < 17 mmHg and 42.6% of failures may be predicted if the IOP > or = 17 mmHg. This study suggests that identification of patients at risk of failure on the basis of IOP in the early post-operative period is possible and that closer follow-up and early medical or surgical intervention may be indicated.
在一项对来自伯明翰和米德兰眼科医院的203例患有单纯性慢性开角型青光眼的白种人患者单眼进行的回顾性研究中，调查了术后眼压（IOP）在预测小梁切除术结果方面的价值。记录了术后第1天、2周、3个月、6个月、12个月和24个月时的眼压。手术失败定义为在整个研究期间眼压达到或高于21 mmHg，到24个月时66只眼出现手术失败（失败率为32.5%）。对术后第一天眼压进行判别分析显示，成功预测可靠性（RPS）和失败预测可靠性（RPF）分别为76.4%和74.4%，成功预测准确率（APS）和失败预测准确率（APF）分别为92.6%和42.6%。在2周时，APS仍然很高（90.3%），而APF随时间增加（63.2%）。在任何阶段成功预测的确定性都很高，失败预测的确定性随时间增加。就术后第一天的眼压而言，如果眼压<17 mmHg，92.6%的成功病例可被正确预测；如果眼压≥17 mmHg，42.6%的失败病例可被预测。这项研究表明，在术后早期根据眼压识别有失败风险的患者是可能的，可能需要更密切的随访以及早期药物或手术干预。
