Chen T C, Wilensky J T, Viana M A
University of Illinois at Chicago Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, USA.
Ophthalmology. 1997 Jul;104(7):1120-5. doi: 10.1016/s0161-6420(97)30174-2.
The purpose was to study the long-term outcomes of primary trabeculectomies that were successful at 1 year.
A retrospective study of patients with various types of glaucoma who had trabeculectomies that were successful at 1 year and who had a follow-up of at least 10 years.
There were 40 patients (40 eyes) who had primary trabeculectomies that were successful at 1 year and who had a follow-up range of 10 to 21 years.
Control of intraocular pressure (IOP) and disease progression was evaluated at 5, 10, and 15 years and at the last obtainable follow-up.
Successful control of IOP was defined as IOP less than 21 mmHg or a reduction of 33% if preoperative IOP was less than 21 mmHg. Successful control of disease progression was defined as stable cup-disc ratios determined by examination, or color photographs or both, as well as stable visual fields.
If an eye was considered successful by IOP at 1 year, the probability of successful control of IOP was 82% at 5 years and 67% at 10 and 15 years. If an eye was considered successful by IOP at 1 year, the probability of successful control of disease progression at 5 years was 77%, at 10 years 61%, and at 15 years 48%. If an eye did not require further glaucoma surgery at 1 year, the probability that it still would not need further surgery at 5 years was 90%, at 10 years 75%, and at 15 years 67%. Forty percent of eyes had cataract extraction by the time of last follow-up examination.
Loss of IOP control and progression of glaucomatous damage occurs over time despite initial success at 1 year.
本研究旨在探讨术后1年成功的原发性小梁切除术的长期疗效。
对各类青光眼患者进行回顾性研究，这些患者接受的小梁切除术在术后1年成功，且随访时间至少为10年。
40例患者（40只眼）接受了术后1年成功的原发性小梁切除术，随访时间为10至21年。
分别于术后5年、10年、15年及最后一次可获得的随访时评估眼压控制情况及疾病进展。
眼压成功控制定义为眼压低于21 mmHg；若术前眼压低于21 mmHg，则眼压降低33%。疾病进展成功控制定义为通过检查、彩色照片或两者确定的杯盘比稳定，以及视野稳定。
若一只眼在术后1年眼压控制成功，则术后5年眼压成功控制的概率为82%，术后10年和15年为67%。若一只眼在术后1年眼压控制成功，则术后5年疾病进展成功控制的概率为77%，术后10年为61%，术后15年为48%。若一只眼在术后1年无需进一步的青光眼手术，则术后5年仍无需进一步手术的概率为90%，术后10年为75%，术后15年为67%。在最后一次随访检查时，40%的眼进行了白内障摘除术。
尽管术后1年取得了初步成功，但随着时间的推移，眼压控制仍会丧失，青光眼损害仍会进展。
