目的:比较单纯行白内障摘除术(CE)的屈光结果,CE与前角切开术(CE/前角切开术),和CE与Schlemm管支架(CE/SCS)插入。
方法:回顾性队列研究。
方法:来自接受CE/前角切开术的BascomPalmer青光眼储存库的眼睛,CE/SCS插入,或仅在2014年7月至2022年2月之间确定了简单的CE。
方法:使用Kruskal-Wallis和Dunn检验对术后1和6个月(POM)的屈光度数据进行分析。屈光参差定义为球形等效(SE)差异≥2D。
方法:主要结果是三个手术组的POM1和POM6的平均屈光度。次要结果是不同房角切开术和SCS装置的屈光度和视力比较。以及屈光参差的发生率。
结果:共有8,360只眼(150CE/前角切开术,395CE/SCS,分析了6059例患者的7,815例CE)。在POM1,CE/性腺切开术中的平均SE,CE/SCS,单独CE组为-0.36±0.91D,-0.31±0.85D,和-0.39±0.88D(p=0.019)。平均logMARVA分别为0.10±0.20、0.08±0.19和0.14±0.26(p=0.002,CE/SCS与CE单独)。在POM6处没有注意到统计学上的显著差异。CE/前角切开术-CE组中有2例患者(13.3%)在POM1发生屈光参差,CE/SCS-CE组中有1名患者(3.2%),CE-CE组184例(4.9%)(p=0.217)。在POM6,平均SE为-0.38±0.97D(CE/前角切开术),-0.35±0.81D(CE/SCS),和-0.40±0.91D(单独CE;p=0.473)。使用不同的SCS或前角切开术装置,观察到总体屈光结果没有显着差异。在原发性开角型青光眼(POAG)/正常眼压青光眼(NTG)中,POM1时的平均SE为-0.36±0.73D(CE/前腺切开术),-0.24±0.84D(CE/SCS),和-0.45±0.81D(单独CE;p<0.001)。
结论:同时插入SCS或进行CE前角切开术与术后屈光度和视力的一些统计学差异有关,尽管这些小幅度差异不太可能具有临床意义.
OBJECTIVE: To compare refractive outcomes in eyes undergoing cataract extraction (CE) alone, CE with
goniotomy (CE/
goniotomy), and CE with Schlemm\'s canal stent (CE/SCS) insertion.
METHODS: Retrospective cohort study.
METHODS: Eyes from the Bascom Palmer Glaucoma Repository undergoing CE/goniotomy, CE/SCS insertion, or uncomplicated CE alone between July 2014 and February 2022 were identified.
METHODS: Refraction data were analyzed at post-operative month (POM) 1 and 6 with Kruskal-Wallis and Dunn\'s tests. Anisometropia was defined as a spherical equivalent (SE) difference of ≥2D.
METHODS: The primary outcome was mean refraction at POM1 and POM6 across the three surgical groups. Secondary outcomes were comparisons of refraction and visual acuity among different
goniotomy and SCS devices, as well as incidence of anisometropia.
RESULTS: A total of 8,360 eyes (150 CE/goniotomy, 395 CE/SCS, and 7,815 CE alone) from 6,059 patients were analyzed. At POM1, mean SE in the CE/
goniotomy, CE/SCS, and CE alone groups was -0.36±0.91D, -0.31±0.85D, and -0.39±0.88D respectively (p=0.019). Mean logMAR VA was 0.10±0.20, 0.08±0.19, and 0.14±0.26 respectively (p=0.002, CE/SCS vs. CE alone). No statistically significant differences were noted at POM6. Anisometropia occurred at POM1 in 2 patients (13.3%) in the CE/goniotomy-CE group, 1 patient (3.2%) in the CE/SCS-CE group, and 184 patients (4.9%) in the CE-CE group (p=0.217). At POM6, mean SEs were -0.38±0.97D (CE/
goniotomy), -0.35±0.81D (CE/SCS), and -0.40±0.91D (CE alone; p=0.473). No significant differences in overall refractive outcomes were observed with different SCS or goniotomy devices. Among primary open-angle glaucoma (POAG) / normal-tension glaucoma (NTG) eyes, mean SE at POM1 was -0.36±0.73D (CE/goniotomy), -0.24±0.84D (CE/SCS), and -0.45±0.81D (CE alone; p<0.001).
CONCLUSIONS: Concurrent SCS insertion or goniotomy with CE was associated with some statistically significant differences in postoperative refraction and visual acuity, although these small magnitude differences were unlikely to be clinically meaningful.