目的:比较120°的疗效和安全性,240°,和360°前角切开术(GT)伴或不伴超声乳化白内障吸除联合人工晶状体植入术(PEI)治疗原发性开角型青光眼(POAG)。
方法:多中心,回顾性,比较,非随机干预研究。
方法:纳入了诊断为POAG的患者,这些患者接受了有或没有PEI的GT,分为六组:(1)独立120°GT,(2)独立240°GT,(3)独立的360°GT,(4)PEI+120°GT,(5)PEI+240°GT,和(6)PEI+360°GT。眼内压(IOP)数据,收集并比较了降眼药物的数量和并发症。成功定义为术后IOP在6至18mmHg范围内,并且在没有进一步青光眼手术的情况下从基线降低20%。完全成功和合格的成功被定义为以上没有和有眼压药物,分别。
结果:纳入231例患者的308只眼,平均随访时间为14.4±8.6个月(6.0-48.0个月)。眼压和药物数量的减少没有显着差异,独立GT和PEI+GT三组中完成和合格成功率的累积生存概率。360°GT组伴或不伴PEI的前房积血比例最高。
结论:120°,240°,和360°GT伴或不伴PEI在降低IOP和POAG中使用的药物方面显示出相似的功效。与120°或240°GT相比,有或没有PEI的360°GT更容易引起前房积血。有或没有PEI的120°GT足以治疗有或没有白内障的POAG。
To compare the efficacy and safety of 120-, 240-, and 360-degree
goniotomy (GT) with or without phacoemulsification with intraocular lens implantation (PEI) for patients with primary open-angle glaucoma (POAG).
Multicenter, retrospective, comparative, nonrandomized interventional study.
Patients diagnosed with POAG who underwent GT with or without PEI were included, and divided into 6 groups: 1) standalone 120-degree GT (120GT); 2) standalone 240-degree GT (240GT); 3) standalone 360-degree GT (360GT); 4) PEI + 120GT; 5) PEI + 240GT; and 6) PEI + 360GT. Data on intraocular pressure (IOP), the number of ocular hypotensive medications, and complications were collected and compared. Success was defined as a postoperative IOP within the range of 6 to 18 mm Hg and a 20% reduction from baseline without further glaucoma surgery. Complete success and qualified success were defined as the above without and with ocular hypotensive medications, respectively.
Three hundred eight eyes of 231 patients were included with a mean follow-up of 14.4 ± 8.6 months (6.0-48.0 months). There were no significant differences in the reductions in IOP and number of medications and cumulative survival probability for complete and qualified success rates among the 3 groups of standalone GT and PEI + GT. The 360GT group had the highest proportion of hyphema with or without PEI.
120GT, 240GT, and 360GT with or without PEI showed similar efficacy in reducing IOP and medications used in POAG. 360GT with or without PEI was more likely to cause hyphema compared with 120GT or 240GT. 120GT with or without PEI was sufficient for treating POAG with or without cataract..