目的:比较Ahmed青光眼瓣膜(AGV)植入术后早期房水抑制(EAS)和标准治疗(ST)的疗效。
方法:回顾性比较队列研究。
方法:2010年1月至2020年10月在西北大学接受AGV植入术的所有葡萄膜性青光眼患者。
方法:不包括术后第一天(POD1),仅首次就诊时IOP≥10mmHg,IOP为10~15mmHg的眼被纳入主要分析.EAS定义为当IOP首先为10-15mmHg时开始眼压低血压治疗。ST在任何以后的时间开始治疗。失效定义为IOP>21mmHg,<5mmHg,或3个月后眼压从基线降低<20%,连续2次研究访问。低眼压定义为≥2次就诊的眼压≤5mmHg。高血压期定义为前3个月连续2次就诊IOP>21mmHg。
方法:获得总体成功的比例;低张力和高血压期的发生率。
结果:EAS组26例28眼,ST组19例20眼,平均随访17.7个月和28.2个月,分别。EAS(31.2±10.1mmHg)和ST(34.6±12.2mmHg)组的基线眼压相似;p=0.18。EAS组的最终IOP(12.9±4.6mmHg)低于ST组(16.4±5.7mmHg;p=0.02),EAS组的2.6±0.9药物和ST组的1.8±1.5(p=0.07)。在87%的EAS眼睛和74%的ST眼睛中实现了总体成功(p=0.43)。额外青光眼手术的发生率没有统计学上的显着差异(EAS的4%,ST为20%;p=0.11),低调(EAS为7%,ST为0%;p=0.50),或高血压期(EAS为4%,ST为21%;p=0.09)。
结论:在葡萄膜青光眼中,EAS与AGV后较低的最终眼压有关;然而,在最后一次访视时使用了更多的药物.总体成功率或不良事件发生率无统计学差异。
OBJECTIVE: To compare outcomes of early aqueous suppression (EAS) and standard therapy (ST) after Ahmed Glaucoma Valve (AGV) implantation for uveitic glaucoma.
METHODS: Retrospective comparative cohort study.
METHODS: All patients with uveitic glaucoma underwent AGV implantation from January 2010 to October 2020 at Northwestern Medicine.
METHODS: Excluding the first postoperative day 1 (POD1), only eyes with IOP 10-15 mmHg at their first visit with IOP ≥ 10 mmHg were included in the main analysis. Early aqueous suppression (EAS) was defined as initiation of ocular hypotensive therapy when IOP was first 10-15 mmHg. Standard therapy was initiation of therapy at any later time. Failure was defined as IOP > 21 mmHg, < 5 mmHg, or < 20% reduction in IOP from baseline after 3 months, for 2 consecutive study visits. Hypotony was defined as IOP ≤ 5 mmHg for ≥ 2 visits. Hypertensive phase was defined as IOP > 21 mmHg for 2 consecutive visits in the first 3 months.
METHODS: Proportion achieving overall success; incidence of hypotony and hypertensive phase.
RESULTS: Twenty-eight eyes of 26 patients were in the EAS group and 20 eyes of 19 patients were in the ST group, with a mean follow-up of 17.7 and 28.2 months, respectively. Baseline IOP was similar in the EAS (31.2 ± 10.1 mmHg) and ST (34.6 ± 12.2 mmHg) groups; P = 0.18. Final IOP was lower in the EAS group (12.9 ± 4.6 mmHg) than the ST group (16.4 ± 5.7 mmHg; P = 0.02) on 2.6 ± 0.9 medications in the EAS group and 1.8 ± 1.5 in the ST group (P = 0.07). Overall success was achieved in 87% of EAS eyes and 74% of ST eyes (P = 0.43). There were no statistically significant differences in the occurrence of additional glaucoma surgery (4% for EAS, 20% for ST; P = 0.11), hypotony (7% for EAS, 0% for ST; P = 0.50), or hypertensive phase (4% for EAS, 21% for ST; P = 0.09).
CONCLUSIONS: EAS was associated with a lower final IOP after AGV in uveitic glaucoma eyes; however, more medications were in use at the final visit. No statistically significant differences in overall success or the incidence of adverse events were observed.
BACKGROUND: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.