Abstract：
OBJECTIVE: To assess the effectiveness and safety of same-site trabeculectomy (TRAB) with mitomycin C (MMC) and Ologen™ (Aeon Astron Europe BV. Leiden, The Netherlands) in patients with a failed non-penetrating deep sclerectomy (NPDS).
METHODS: A retrospective study of 24 consecutive eyes (22 patients) undergoing reintervention by same-site TRAB with at least one-year follow-up after failed NPDS. Mean visual acuity (VA), intraocular pressure (IOP) and use of glaucoma medications were compared before and one year after surgery. Early and late postoperative complications were registered. Kaplan-Meier survival analysis was performed according to four levels of success criteria.
RESULTS: Overall the mean IOP reduced significantly (24.9 ± 7.1 vs. 14.4 ± 4.5 mmHg; p < 0.001), and the number of glaucoma medications (2.80 ± 1.01 vs. 0.55 ± 0.94; p < 0.001) significantly decreased, one year after surgery. The mean VA remained stable one year after surgery (p = 0.516). Hypotony, defined as IOP ≤ 5 mmHg, in the early postoperative period was observed in 62.5% of eyes, but only in 2 patients (8.33%) in the long term. The mean survival time ranged from 10 months (CI 95% 5-15) to 29 months (CI 95%: 26-32) according to the most stringent and lenient success criteria respectively.
CONCLUSIONS: Same-site TRAB augmented with MMC and Ologen™ may provide an effective, safe and lasting alternative following failed NPDS, especially when sparing of the conjunctiva is highly desirable. Postoperative hypotony is the most common postoperative complication.
METHODS: A retrospective study of 24 consecutive eyes (22 patients) undergoing reintervention by same-site TRAB with at least one-year follow-up after failed NPDS. Mean visual acuity (VA), intraocular pressure (IOP) and use of glaucoma medications were compared before and one year after surgery. Early and late postoperative complications were registered. Kaplan-Meier survival analysis was performed according to four levels of success criteria.
RESULTS: Overall the mean IOP reduced significantly (24.9 ± 7.1 vs. 14.4 ± 4.5 mmHg; p < 0.001), and the number of glaucoma medications (2.80 ± 1.01 vs. 0.55 ± 0.94; p < 0.001) significantly decreased, one year after surgery. The mean VA remained stable one year after surgery (p = 0.516). Hypotony, defined as IOP ≤ 5 mmHg, in the early postoperative period was observed in 62.5% of eyes, but only in 2 patients (8.33%) in the long term. The mean survival time ranged from 10 months (CI 95% 5-15) to 29 months (CI 95%: 26-32) according to the most stringent and lenient success criteria respectively.
CONCLUSIONS: Same-site TRAB augmented with MMC and Ologen™ may provide an effective, safe and lasting alternative following failed NPDS, especially when sparing of the conjunctiva is highly desirable. Postoperative hypotony is the most common postoperative complication.
摘要：
目的：评估使用丝裂霉素C（MMC）和Ologen™（AeonAstronEuropeBV。莱顿,荷兰）非穿透性深层巩膜切除术（NPDS）失败的患者。
方法：一项回顾性研究，对24只连续的眼睛（22例患者）进行了同部位TRAB的再干预，并在NPDS失败后进行了至少一年的随访。平均视敏度（VA），比较手术前和手术后1年的眼内压(IOP)和青光眼药物使用情况.记录术后早期和晚期并发症。根据四个水平的成功标准进行Kaplan-Meier生存分析。
结果：总体上平均IOP显着降低（24.9±7.1vs.14.4±4.5mmHg；p<0.001），和青光眼药物的数量（2.80±1.01vs.0.55±0.94；p<0.001）显着下降，手术后一年.手术后一年平均VA保持稳定（p=0.516）。低调，定义为IOP≤5mmHg，在术后早期观察到62.5%的眼睛，但只有2例患者（8.33%）长期。根据最严格和最宽松的成功标准，平均生存时间分别为10个月（CI95％5-15）至29个月（CI95％：26-32）。
结论：用MMC和Ologen™增强的同部位TRAB可能提供有效的，NPDS失败后的安全和持久的替代方案，特别是当保留结膜是非常可取的。术后低眼压是最常见的术后并发症。
方法：一项回顾性研究，对24只连续的眼睛（22例患者）进行了同部位TRAB的再干预，并在NPDS失败后进行了至少一年的随访。平均视敏度（VA），比较手术前和手术后1年的眼内压(IOP)和青光眼药物使用情况.记录术后早期和晚期并发症。根据四个水平的成功标准进行Kaplan-Meier生存分析。
结果：总体上平均IOP显着降低（24.9±7.1vs.14.4±4.5mmHg；p<0.001），和青光眼药物的数量（2.80±1.01vs.0.55±0.94；p<0.001）显着下降，手术后一年.手术后一年平均VA保持稳定（p=0.516）。低调，定义为IOP≤5mmHg，在术后早期观察到62.5%的眼睛，但只有2例患者（8.33%）长期。根据最严格和最宽松的成功标准，平均生存时间分别为10个月（CI95％5-15）至29个月（CI95％：26-32）。
结论：用MMC和Ologen™增强的同部位TRAB可能提供有效的，NPDS失败后的安全和持久的替代方案，特别是当保留结膜是非常可取的。术后低眼压是最常见的术后并发症。
