PDF(Pubmed)
Abstract：
UNASSIGNED: To evaluate the 2-year efficacy and safety of Kahook dual-blade (KDB) goniotomy in patients with medically uncontrolled glaucoma.
UNASSIGNED: This was a retrospective case-series study of 90 consecutive patients with primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEXG) that underwent KDB goniotomy alone (KDB-alone group) or KDB goniotomy in combination with phacoemulsification (KDB-phaco group) during 2019-2020. All patients were uncontrolled on three or more medications. Surgical success was defined as an IOP reduction ≥20% and/or a reduction of one or more medications at 24 months. We also report IOP levels and number of medications from baseline to 24 months, as well as the need for further glaucoma interventions.
UNASSIGNED: At 24 months, mean IOP had reduced from 24.8±8.3 to 15.0±5.3 mmHg in the KDB-alone group (P<0.001) and from 22.3±5.8 to 13.9±3.0 mmHg in the KDB-phaco group (P<0.001). Medications had reduced from 3.5±0.6 to 3.1±0.9 in the KDB-alone group (P=0.047) and from 3.3±0.5 to 2.3±1.1 in the KDB-phaco group (P<0.001). An IOP reduction ≥20% and/or a reduction with one or more medications was achieved by 47% of eyes in the KDB-alone group and by 76% of eyes in the KDB-phaco group. Eyes with PEXG and POAG responded equally well to the success criteria. During the 24-month follow-up, additional glaucoma surgery or transscleral photocoagulation was performed in 28% of eyes in the KDB-alone group and in 12% of eyes in the KDB-phaco group.
UNASSIGNED: In patients with medically uncontrolled glaucoma, KDB had a significant IOP-lowering effect after 24 months, but success rates were higher when KDB was performed in combination with cataract surgery compared to stand-alone treatment.
UNASSIGNED: This was a retrospective case-series study of 90 consecutive patients with primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEXG) that underwent KDB goniotomy alone (KDB-alone group) or KDB goniotomy in combination with phacoemulsification (KDB-phaco group) during 2019-2020. All patients were uncontrolled on three or more medications. Surgical success was defined as an IOP reduction ≥20% and/or a reduction of one or more medications at 24 months. We also report IOP levels and number of medications from baseline to 24 months, as well as the need for further glaucoma interventions.
UNASSIGNED: At 24 months, mean IOP had reduced from 24.8±8.3 to 15.0±5.3 mmHg in the KDB-alone group (P<0.001) and from 22.3±5.8 to 13.9±3.0 mmHg in the KDB-phaco group (P<0.001). Medications had reduced from 3.5±0.6 to 3.1±0.9 in the KDB-alone group (P=0.047) and from 3.3±0.5 to 2.3±1.1 in the KDB-phaco group (P<0.001). An IOP reduction ≥20% and/or a reduction with one or more medications was achieved by 47% of eyes in the KDB-alone group and by 76% of eyes in the KDB-phaco group. Eyes with PEXG and POAG responded equally well to the success criteria. During the 24-month follow-up, additional glaucoma surgery or transscleral photocoagulation was performed in 28% of eyes in the KDB-alone group and in 12% of eyes in the KDB-phaco group.
UNASSIGNED: In patients with medically uncontrolled glaucoma, KDB had a significant IOP-lowering effect after 24 months, but success rates were higher when KDB was performed in combination with cataract surgery compared to stand-alone treatment.
摘要：
■评估Kahook双刀（KDB）性腺切开术在医学上未控制的青光眼患者中的2年疗效和安全性。
■这是一项回顾性病例系列研究，对90例原发性开角型青光眼（POAG）或假性剥脱性青光眼（PEXG）的连续患者进行了单独的KDB性腺切开术（KDB单独组）或KDB性腺切开术在2019-2020年期间联合超声乳化术（KDB-phaco组）。所有患者在三种或更多种药物上都不受控制。手术成功定义为在24个月时IOP降低≥20%和/或一种或多种药物减少。我们还报告了从基线到24个月的IOP水平和药物数量，以及需要进一步的青光眼干预措施。
■在24个月时，KDB单药组的平均IOP从24.8±8.3降至15.0±5.3mmHg(P<0.001),KDB-phaco组的平均IOP从22.3±5.8降至13.9±3.0mmHg(P<0.001).单独KDB组的药物治疗从3.5±0.6降至3.1±0.9（P=0.047），KDB-phaco组的药物治疗从3.3±0.5降至2.3±1.1（P<0.001）。单用KDB组的47％的眼睛和KDB-phaco组的76％的眼睛实现了IOP降低≥20％和/或一种或多种药物的降低。PEXG和POAG的眼睛对成功标准的反应同样良好。在24个月的随访中，在KDB单独治疗组中28%的眼和KDB-phaco组中12%的眼进行了额外的青光眼手术或经巩膜光凝治疗.
■在药物控制的青光眼患者中，KDB在24个月后有明显的降低IOP的作用，但与独立治疗相比,KDB联合白内障手术的成功率更高.
■这是一项回顾性病例系列研究，对90例原发性开角型青光眼（POAG）或假性剥脱性青光眼（PEXG）的连续患者进行了单独的KDB性腺切开术（KDB单独组）或KDB性腺切开术在2019-2020年期间联合超声乳化术（KDB-phaco组）。所有患者在三种或更多种药物上都不受控制。手术成功定义为在24个月时IOP降低≥20%和/或一种或多种药物减少。我们还报告了从基线到24个月的IOP水平和药物数量，以及需要进一步的青光眼干预措施。
■在24个月时，KDB单药组的平均IOP从24.8±8.3降至15.0±5.3mmHg(P<0.001),KDB-phaco组的平均IOP从22.3±5.8降至13.9±3.0mmHg(P<0.001).单独KDB组的药物治疗从3.5±0.6降至3.1±0.9（P=0.047），KDB-phaco组的药物治疗从3.3±0.5降至2.3±1.1（P<0.001）。单用KDB组的47％的眼睛和KDB-phaco组的76％的眼睛实现了IOP降低≥20％和/或一种或多种药物的降低。PEXG和POAG的眼睛对成功标准的反应同样良好。在24个月的随访中，在KDB单独治疗组中28%的眼和KDB-phaco组中12%的眼进行了额外的青光眼手术或经巩膜光凝治疗.
■在药物控制的青光眼患者中，KDB在24个月后有明显的降低IOP的作用，但与独立治疗相比,KDB联合白内障手术的成功率更高.
