Abstract:
This study compared the efficacy of modified CO2 laser-assisted sclerectomy surgery (CLASS) with combined CLASS and trabeculectomy (CLASS-TRAB) in patients with uveitic glaucoma (UG). UG patients who underwent CLASS-TRAB between August 2015 and April 2019 were retrospectively compared with a control group who underwent a modified CLASS standalone procedure during the same period. Visual acuity, intraocular pressure (IOP), use of supplemental medical therapy and postoperative complications were recorded at baseline, 1 week, 3 months, 6 months and 12 months. Forty patients (40 eyes) were enrolled, and each group had 20 patients (20 eyes). The age and sex distribution were matched between groups (P > 0.05). Both the preoperative IOP (CLASS: 34.9 ± 9.3 mmHg, CLASS-TRAB: 36.8 ± 8.7 mmHg; P > 0.05) and number of glaucoma medications (CLASS: 3.3 ± 0.4, CLASS-TRAB: 3.5 ± 0.5; P > 0.05) were relatively higher in the CLASS-TRAB group than in the CLASS group. At the final follow-up, the IOP (CLASS: 12.9 ± 3.4 mmHg, CLASS-TRAB: 11.2 ± 2.5 mmHg) and number of glaucoma medications (CLASS: 0.4 ± 0.7 and CLASS-TRAB: 0.2 ± 0.5) significantly decreased in both groups (P < 0.01). Both the complete success rate and qualified success rate were comparable between the two groups (CLASS versus CLASS-TRAB: 55% versus 80%, P = 0.09; 80% versus 95%, P = 0.34). CLASS-TRAB is as efficient as modified CLASS in terms of the IOP-lowering effect, providing a new option for patients with UG that is severe and ineligible for other treatments.
摘要:
这项研究比较了改良CO2激光辅助巩膜切除术(CLASS)与CLASS和小梁切除术(CLASS-TRAB)联合治疗葡萄膜青光眼(UG)的疗效。在2015年8月至2019年4月期间接受CLASS-TRAB的UG患者与同期接受改良CLASS独立手术的对照组进行回顾性比较。视敏度,眼内压(IOP),基线时记录补充药物治疗的使用和术后并发症,1周,3个月,6个月和12个月。纳入40例患者(40只眼),每组20例(20只眼)。组间年龄、性别分布比较差异无统计学意义(P>0.05)。术前眼压(CLASS:34.9±9.3mmHg,CLASS-TRAB组:36.8±8.7mmHg;P>0.05)和青光眼药物数量(CLASS:3.3±0.4,CLASS-TRAB:3.5±0.5;P>0.05)相对高于CLASS组。在最后的后续行动中,眼压(等级:12.9±3.4mmHg,CLASS-TRAB:11.2±2.5mmHg)和青光眼药物数量(CLASS:0.4±0.7和CLASS-TRAB:0.2±0.5)两组均显着减少(P<0.01)。两组之间的完全成功率和合格成功率具有可比性(CLASS与CLASS-TRAB:55%与80%,P=0.09;80%对95%,P=0.34)。CLASS-TRAB在降低IOP的作用方面与改良CLASS一样有效,为严重且不适合其他治疗的UG患者提供新的选择。