Abstract：
OBJECTIVE: To evaluate the long-term efficacy of endoscopic cyclophotocoagulation (ECP) via a pars plana approach in a large cohort of refractory glaucoma patients DESIGN: Single-center, retrospective, longitudinal, cohort study.
METHODS: This study recruited patients who underwent ECP and consecutively visited and were followed up for at least 5 years at Beijing Tongren Eye Center, China from January 2013 to December 2017. All patients underwent a complete ophthalmic examination. Treatment success was defined as 6 mmHg ≤ IOP ≤ 21 mmHg with or without anti-glaucoma medications.
RESULTS: A total of 121 eyes of 105 patients including 51 children and 54 adults were enrolled. The mean follow-up was 7.2 ± 1.3 years. The most common glaucoma diagnoses were secondary glaucoma (74 eyes, 61.1 %) and primary congenital glaucoma (19 eyes 15.7 %). The mean extent of the first ECP was 259 degrees. There was an overall decrease in IOP of 38.3 % from 33.3 ± 9.0 mmHg preoperatively to 20.5 ± 7.5 mmHg after surgery, which was statistically significant (P < 0.001). The success rate after 1 or more ECP surgery was 65.3 %. After adjusting for sex, number of prior TCP surgeries and the extent of ECP degree, the failure of ECP was associated with being children (as compared with adults; P = 0.028; OR = 2.549) and higher preoperative IOP (P = 0.001; OR = 1.084).
CONCLUSIONS: ECP is an effective procedure for lowing IOP in refractory glaucoma, particularly in patients who are also candidates for vitreoretinal interventions. Hence, a collaborative approach between glaucoma and retinal specialists is of utmost importance in devising an optimal management strategy for glaucoma treatment.
METHODS: This study recruited patients who underwent ECP and consecutively visited and were followed up for at least 5 years at Beijing Tongren Eye Center, China from January 2013 to December 2017. All patients underwent a complete ophthalmic examination. Treatment success was defined as 6 mmHg ≤ IOP ≤ 21 mmHg with or without anti-glaucoma medications.
RESULTS: A total of 121 eyes of 105 patients including 51 children and 54 adults were enrolled. The mean follow-up was 7.2 ± 1.3 years. The most common glaucoma diagnoses were secondary glaucoma (74 eyes, 61.1 %) and primary congenital glaucoma (19 eyes 15.7 %). The mean extent of the first ECP was 259 degrees. There was an overall decrease in IOP of 38.3 % from 33.3 ± 9.0 mmHg preoperatively to 20.5 ± 7.5 mmHg after surgery, which was statistically significant (P < 0.001). The success rate after 1 or more ECP surgery was 65.3 %. After adjusting for sex, number of prior TCP surgeries and the extent of ECP degree, the failure of ECP was associated with being children (as compared with adults; P = 0.028; OR = 2.549) and higher preoperative IOP (P = 0.001; OR = 1.084).
CONCLUSIONS: ECP is an effective procedure for lowing IOP in refractory glaucoma, particularly in patients who are also candidates for vitreoretinal interventions. Hence, a collaborative approach between glaucoma and retinal specialists is of utmost importance in devising an optimal management strategy for glaucoma treatment.
摘要：
目的：评价经半平面入路内镜下睫状体光凝（ECP）治疗难治性青光眼患者的长期疗效设计：单中心，回顾性,纵向,队列研究。
方法：本研究招募了在北京同仁市眼科中心连续就诊并随访至少5年的ECP患者，中国从2013年1月到2017年12月。所有患者都接受了完整的眼科检查。治疗成功定义为6mmHg≤IOP≤21mmHg，有或没有抗青光眼药物。
结果：共纳入105名患者的121只眼，包括51名儿童和54名成人。平均随访时间为7.2±1.3年。最常见的青光眼诊断是继发性青光眼（74眼，61.1％）和原发性先天性青光眼（19眼15.7％）。第一次ECP的平均程度为259度。术前33.3±9.0mmHg至术后20.5±7.5mmHg的眼压总体下降38.3%,有统计学意义(P<0.001)。1次及以上ECP手术成功率为65.3%。在适应性爱之后，先前的TCP手术次数和ECP程度，ECP失败与儿童(与成人相比,P=0.028;OR=2.549)和术前IOP较高(P=0.001;OR=1.084)相关.
结论：ECP是降低难治性青光眼眼压的有效方法，特别是在也是玻璃体视网膜干预的候选人的患者中。因此，青光眼和视网膜专家之间的合作方法对于设计青光眼治疗的最佳管理策略至关重要。
方法：本研究招募了在北京同仁市眼科中心连续就诊并随访至少5年的ECP患者，中国从2013年1月到2017年12月。所有患者都接受了完整的眼科检查。治疗成功定义为6mmHg≤IOP≤21mmHg，有或没有抗青光眼药物。
结果：共纳入105名患者的121只眼，包括51名儿童和54名成人。平均随访时间为7.2±1.3年。最常见的青光眼诊断是继发性青光眼（74眼，61.1％）和原发性先天性青光眼（19眼15.7％）。第一次ECP的平均程度为259度。术前33.3±9.0mmHg至术后20.5±7.5mmHg的眼压总体下降38.3%,有统计学意义(P<0.001)。1次及以上ECP手术成功率为65.3%。在适应性爱之后，先前的TCP手术次数和ECP程度，ECP失败与儿童(与成人相比,P=0.028;OR=2.549)和术前IOP较高(P=0.001;OR=1.084)相关.
结论：ECP是降低难治性青光眼眼压的有效方法，特别是在也是玻璃体视网膜干预的候选人的患者中。因此，青光眼和视网膜专家之间的合作方法对于设计青光眼治疗的最佳管理策略至关重要。
