METHODS: Medical records from 2008 to April 2022 were reviewed. All patients selected had an AVG performed first. Following valve failure, lensectomy-ECP was performed in addition to bleb resection as indicated. Additional ECP and AVG replacement surgeries were performed as deemed medically necessary. Main outcomes evaluated included vision preservation, average IOP reduction, and the number of glaucoma medications (both oral and topical) at 6, 12, 24, and 36 months.
RESULTS: Fourteen eyes from 13 patients were included in the study. Females were predominant (n = 9) compared with males (n = 4). Mean age at initial glaucoma diagnosis was 6.82 years. Following AVG and lensectomy-ECP, vision was preserved in 93%, 84%, 60%, and 48% of eyes at 1, 2, 3, and 4 years respectively. Following lensectomy-ECP, there was a significant reduction in mean IOP of 9.64 mmHg (p = .015) and 9.71 mmHg (p = .016) at 2 and 6 months, respectively. There was a reduction in mean IOP of 2.45, 7.25, and 12.25 mmHg at 12, 24, and 36 months, respectively, which was not statistically significant. There was a significant decrease in the number of glaucoma medications at all evaluated time points except 24 months.
CONCLUSIONS: Combined AVG and lensectomy-ECP is successful in maintaining vision long term as well as decreasing IOP, and the number of glaucoma medications administered.
方法:回顾了2008年至2022年4月的病历。所有选择的患者首先进行了AVG。阀门故障后,除显示的气泡切除术外,还进行了晶状体切除术-ECP。在认为医学上必要时进行了额外的ECP和AVG置换手术。评估的主要结果包括视力保留,平均IOP降低,以及6、12、24和36个月时青光眼药物(口服和外用)的数量。
结果:本研究纳入了13例患者的14只眼。与男性(n=4)相比,女性占主导地位(n=9)。初次诊断青光眼的平均年龄为6.82岁。在AVG和晶状体切除术-ECP之后,视力保留在93%,84%,60%,1、2、3和4岁时分别有48%的眼睛。晶状体切除术-ECP后,在2个月和6个月时,平均IOP显着降低了9.64mmHg(p=.015)和9.71mmHg(p=.016),分别。在12、24和36个月时,平均IOP降低了2.45、7.25和12.25mmHg,分别,这没有统计学意义。除24个月外,所有评估时间点的青光眼药物数量均显着减少。
结论:联合AVG和晶状体切除术-ECP在长期维持视力以及降低IOP方面是成功的,和服用青光眼药物的数量。