■为了报告使用Kahook双刀(KDB)成功切除性腺切开术的临床结果,通过60个月。
■这是一个非比较性的,单外科医生,回顾性回顾2015年10月至2016年1月期间成功进行KDB切开术伴或不伴行白内障超声乳化术的眼睛,并进行5年不间断随访.眼内压(IOP),青光眼药物的数量,最佳矫正视力(BCVA),并记录并发症。主要结果包括眼压基线的变化,药物使用,和BCVA,通过五年。
■对28例患者52只眼进行分析。大多数眼睛患有轻度原发性开角型青光眼(73%)。被分析的眼睛,41例接受联合手术,11例接受独立手术。所有的眼睛结合在一起,平均(标准差)基线IOP为21.0(4.1)mmHg,平均基线用药为每眼1.8(1.1)次.在6、12、24、36、48和60个月的时间点,术后平均IOP范围为13.0至13.7mmHg,代表平均降低7.3-8.0mmHg(34.7-38.3%;每个时间点p<0.0001)。同样,平均药物使用量为每只眼睛0.4至0.6种药物,代表1.2-1.4种药物的平均减少(66-75.5%;每个时间点的p<0.0001)。平均logMARBCVA从术前的0.321(0.177)提高到60个月的0.015(0.035)(p<0.0001)。
■在不需要二次外科手术的眼睛中(例如,长期手术成功),切除前角切开术在临床上和统计学上均显著降低了IOP和对药物的需求,这在5年的随访中高度一致.在基线时使用≥1种降低IOP的药物且没有眼部手术史的高加索开角型青光眼患者中,KDB切开术似乎非常成功。通过降低眼压,可以预期使用KDB成功的房角切开术将改善与青光眼相关的长期视力结果,并通过减少药物治疗改善生活质量。
UNASSIGNED: To report clinical outcomes of successful excisional
goniotomy with the Kahook Dual Blade (KDB), through 60 months.
UNASSIGNED: This was a noncomparative, single-surgeon, retrospective review of eyes receiving successful KDB
goniotomy with or without concomitant phacoemulsification between October 2015 and January 2016 with five years of uninterrupted follow-up. Intraocular pressure (IOP), number of glaucoma medications, best corrected visual acuity (BCVA), and complications were recorded. Primary outcomes included changes from baseline in IOP, medication use, and BCVA, through five years.
UNASSIGNED: Fifty-two eyes of 28 patients were analyzed. Most eyes had mild primary open angle glaucoma (73%). Of the eyes analyzed, 41 underwent combined surgery and 11 underwent standalone surgery. With all eyes combined, mean (standard deviation) baseline IOP was 21.0 (4.1) mmHg and mean baseline medication use was 1.8 (1.1) medications per eye. Across time points at months 6, 12, 24, 36, 48, and 60, mean postoperative IOP ranged from 13.0 to 13.7 mmHg, representing mean reductions of 7.3-8.0 mmHg (34.7-38.3%; p <0.0001 at every time point). Similarly, mean medication use ranged from 0.4 to 0.6 medications per eye, representing mean reductions of 1.2-1.4 medications (66-75.5%; p <0.0001 at every time point). Mean logMAR BCVA improved from 0.321 (0.177) preoperatively to 0.015 (0.035) at month 60 (p < 0.0001).
UNASSIGNED: In eyes not requiring secondary surgical procedures (eg, long-term surgical successes), excisional
goniotomy provided clinically and statistically significant reductions in both IOP and the need for medications that were highly consistent through five years of follow-up. KDB
goniotomy appears to be highly successful in Caucasian patients with open angle glaucoma on ≥1 IOP-lowering medications at baseline and with no history of prior ocular surgery. Successful excisional
goniotomy with the KDB can be expected to improve long-term glaucoma-related visual outcomes through IOP reduction and to improve quality of life through medication reduction.