目的:确定在无并发症的Baerveldt青光眼植入术(BGI)术后(90天)需要额外干预的平坦前房的危险因素。
方法:回顾性,匹配的病例对照研究方法:纳入2011年2月1日至2019年1月1日在AnneBatesLeach眼科医院接受BGI治疗且前房平坦的患者42(42)例(眼).对于每种情况,我们匹配了两个对照(84)。变量包括性别,诊断,糖尿病,高血压,术前/术后青光眼药物,眼部状况,和眼内压(IOP)。多变量条件逻辑回归确定独立预测因子的比值比(OR)。
结果:病例更可能是女性(69.1%病例/41.7%对照),有在管口服用口服碳酸酐酶抑制剂(CAI)的病史(21.4%/7.1%),属于另一个种族/族裔(11.9%/0.0%),并且有假性剥脱(23.8%/6.0%);并且在基线时使用胆碱能激动剂(0.0%/11.9%)的可能性较小,并且患有原发性开角型青光眼(42.9%/64.3%)。病例的平均年龄更大(75.9/64.9岁),较早的开管时间(5.6/6.2周),管打开后眼压降低(7.2/14.4mmHg),但开放前眼压较高(24.7/19.5mmHg)。我们确定了三个独立的预测因素:年龄较大(10年增加OR=3.59p<0.0001),在管开口处使用口服CAI(OR=5.65,p=0.009),管口前眼压较高(3mmHg增加OR=1.30,p=0.018)。
结论:平坦前房的危险因素是年龄较大,导管开口处的口腔CAIs,和更高的IOP之前管打开。可以考虑将这种并发症之前的急性眼压降低降至最低的策略,例如在开管之前停止口服CAI。
To identify risk factors for flat anterior chamber that required additional intervention in the postoperative period (90 days) after uncomplicated Baerveldt Glaucoma Implant (BGI) surgery.
Retrospective, matched
case-control study.
A total of 42 cases (eyes) that received BGI at Anne Bates Leach Eye Hospital between February 1, 2011, and January 1, 2019, and that developed flat anterior chamber were included. For each
case, we matched 2 controls (84). Variables included sex, diagnosis, diabetes, hypertension, pre- and postoperative glaucoma medications, ocular conditions, and intraocular pressure (IOP). Multivariable conditional logistic regression determined odds ratios (ORs) for independent predictors.
Case patients were more likely to be female (69.1%
case patients/41.7% controls), to have a history of taking oral carbonic anhydrase inhibitors (CAIs) at tube opening (21.4%/7.1%), to be of another race/ethnicity (11.9%/0.0%), and to have pseudoexfoliation (23.8%/6.0%), and were less likely to be using cholinergic agonists (0.0%/11.9%) at baseline and to have primary open angle glaucoma (42.9%/64.3%).
Case patients had greater mean age (75.9/64.9 years), earlier tube opening time (5.6/6.2 weeks), and lower IOP after tube opening (7.2/14.4 mm Hg), but IOP before opening was higher (24.7/19.5 mm Hg). We identified 3 independent predictors: older age (10-year increase OR = 3.59, P < .0001), oral CAI use at tube opening (OR = 5.65, P = .009), and higher IOP prior to tube opening (3 mm Hg increase OR = 1.30, P = .018).
Risk factors for flat anterior chamber were older age, oral CAIs at tube opening, and higher IOP before tube opening. Strategies to minimize the acute IOP reduction that preceded this complication such as discontinuing oral CAI prior to tube opening may be considered.