PDF(Pubmed)
Abstract：
UNASSIGNED: To compare the surgical outcomes of trabeculectomy with and without anti-metabolites in patients with juvenile open-angle glaucoma (JOAG).
UNASSIGNED: This retrospective comparative case series included 98 eyes of 66 patients with JOAG who underwent either trabeculectomy without anti-metabolites (group A, n = 53 eyes) or with anti-metabolites (group B, n = 45 eyes) with a minimum of 2 years follow-up. The main outcome measures were intra-ocular pressure (IOP), number of glaucoma medications, visual acuity, additional surgical interventions, surgical complications, and risk factors for failure. Surgical failure was defined as IOP >18 mmHg or failure to reduce IOP by <30% from the baseline value or IOP ≤5 mmHg or re-operation for refractory glaucoma or a complication or loss of light perception vision.
UNASSIGNED: The mean post-operative IOP reduced significantly from baseline at all post-operative visits until 6 months and thereafter. The cumulative probability of failure at 2 years was 28.7% in group A [95% confidence interval (CI) = 17.6-44.8%] and 29.1% in group B (95% CI = 17.1-46.7%) (P = 0.78). Surgical complications occurred in 18 eyes (34%) in group A and 19 eyes (42%) in group B. Re-operations for glaucoma or complications were performed in two eyes (3.8%) in group A and two eyes (4.4%) in group B. Cox-hazard regression model revealed male gender (HR = 0.29; P = 0.008), baseline high IOP (HR = 0.95; P = 0.002), and an increased number of pre-operative glaucoma medications (HR = 2.08; P = 0.010) as significant factors associated with failure.
UNASSIGNED: : Our study results on trabeculectomy in JOAG revealed a success of 71% in both groups at 2 years follow-up. There was no significant difference in success or failure rates between the two groups. The risk factors for poor surgical outcome in JOAG were male gender, baseline high IOP, and an increased number of glaucoma medications.
UNASSIGNED: This retrospective comparative case series included 98 eyes of 66 patients with JOAG who underwent either trabeculectomy without anti-metabolites (group A, n = 53 eyes) or with anti-metabolites (group B, n = 45 eyes) with a minimum of 2 years follow-up. The main outcome measures were intra-ocular pressure (IOP), number of glaucoma medications, visual acuity, additional surgical interventions, surgical complications, and risk factors for failure. Surgical failure was defined as IOP >18 mmHg or failure to reduce IOP by <30% from the baseline value or IOP ≤5 mmHg or re-operation for refractory glaucoma or a complication or loss of light perception vision.
UNASSIGNED: The mean post-operative IOP reduced significantly from baseline at all post-operative visits until 6 months and thereafter. The cumulative probability of failure at 2 years was 28.7% in group A [95% confidence interval (CI) = 17.6-44.8%] and 29.1% in group B (95% CI = 17.1-46.7%) (P = 0.78). Surgical complications occurred in 18 eyes (34%) in group A and 19 eyes (42%) in group B. Re-operations for glaucoma or complications were performed in two eyes (3.8%) in group A and two eyes (4.4%) in group B. Cox-hazard regression model revealed male gender (HR = 0.29; P = 0.008), baseline high IOP (HR = 0.95; P = 0.002), and an increased number of pre-operative glaucoma medications (HR = 2.08; P = 0.010) as significant factors associated with failure.
UNASSIGNED: : Our study results on trabeculectomy in JOAG revealed a success of 71% in both groups at 2 years follow-up. There was no significant difference in success or failure rates between the two groups. The risk factors for poor surgical outcome in JOAG were male gender, baseline high IOP, and an increased number of glaucoma medications.
摘要：
■比较青少年开角型青光眼（JOAG）患者使用和不使用抗代谢物小梁切除术的手术效果。
■这项回顾性比较病例系列包括66例JOAG患者的98只眼，这些患者在没有抗代谢物的情况下接受了小梁切除术（A组，n=53只眼）或使用抗代谢物（B组，n=45只眼），至少随访2年。主要结局指标为眼内压(IOP),青光眼药物的数量，视敏度,额外的手术干预，手术并发症,和失败的风险因素。手术失败定义为IOP>18mmHg或IOP未能从基线值降低<30％或IOP≤5mmHg或难治性青光眼再次手术或并发症或光感知视力丧失。
■在所有术后随访中，直到6个月及之后，平均术后IOP从基线显着降低。A组2年的累积失败概率为28.7%[95%置信区间(CI)=17.6-44.8%]，B组为29.1%(95%CI=17.1-46.7%)(P=0.78)。A组18只眼（34％），B组19只眼（42％）发生手术并发症。A组2只眼（3.8％），B组2只眼（4.4％）进行青光眼再手术或并发症。Cox风险回归模型显示男性（HR=0.29；P=0.008），基线高眼压（HR=0.95；P=0.002），术前青光眼药物治疗的数量增加（HR=2.08;P=0.010）是与失败相关的重要因素。
■：我们在JOAG中小梁切除术的研究结果显示，在2年的随访中，两组的成功率均为71％。两组之间的成功率或失败率没有显着差异。JOAG中不良手术结局的危险因素为男性,基线高IOP,和青光眼药物的增加。
■这项回顾性比较病例系列包括66例JOAG患者的98只眼，这些患者在没有抗代谢物的情况下接受了小梁切除术（A组，n=53只眼）或使用抗代谢物（B组，n=45只眼），至少随访2年。主要结局指标为眼内压(IOP),青光眼药物的数量，视敏度,额外的手术干预，手术并发症,和失败的风险因素。手术失败定义为IOP>18mmHg或IOP未能从基线值降低<30％或IOP≤5mmHg或难治性青光眼再次手术或并发症或光感知视力丧失。
■在所有术后随访中，直到6个月及之后，平均术后IOP从基线显着降低。A组2年的累积失败概率为28.7%[95%置信区间(CI)=17.6-44.8%]，B组为29.1%(95%CI=17.1-46.7%)(P=0.78)。A组18只眼（34％），B组19只眼（42％）发生手术并发症。A组2只眼（3.8％），B组2只眼（4.4％）进行青光眼再手术或并发症。Cox风险回归模型显示男性（HR=0.29；P=0.008），基线高眼压（HR=0.95；P=0.002），术前青光眼药物治疗的数量增加（HR=2.08;P=0.010）是与失败相关的重要因素。
■：我们在JOAG中小梁切除术的研究结果显示，在2年的随访中，两组的成功率均为71％。两组之间的成功率或失败率没有显着差异。JOAG中不良手术结局的危险因素为男性,基线高IOP,和青光眼药物的增加。
