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首页> 外文期刊>Journal of glaucoma >Effect of a failed trabectome on subsequent trabeculectomy
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Effect of a failed trabectome on subsequent trabeculectomy

机译：失败的小梁切除器对随后的小梁切除术的影响

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摘要

PURPOSE: To determine the effect of a failed trabectome on the outcomes of a subsequent trabeculectomy. PATIENTS AND METHODS: A cohort study of eyes that underwent trabeculectomy after a failed trabectome procedure (study) compared with eyes that underwent trabeculectomy as an initial surgical procedure (control). Inclusion criteria were open-angle glaucoma, age ≥18 years, and uncontrolled glaucoma with maximally tolerated medical therapy. Exclusion criteria were concurrent surgery and follow-up less than 6 months. Outcome measures were intraocular pressure (IOP), success rate, and occurrence of complications. Failure was the occurrence of additional glaucoma surgery, loss of light perception vision, or IOP >21 mm Hg, ≤5 mm Hg, or <20% reduction below baseline on 2 consecutive follow-up visits after 1 month. RESULTS: Mean follow-up was 15.4 months and 18.6 months for study (n=34) and control (n=42) groups, respectively. IOP decreased from 27.6±11.8 mm Hg at baseline to 10.6±2.6 mm Hg at 2 years in study group, and 29.2±11.4 mm Hg to 11.0±5.4 mm Hg in the control group. The success rates at 2 years were 60.2% and 55.5% in the study and control groups, respectively (P=0.895). Systemic hypertension [P=0.009; adjusted hazard ratio, 4.03; 95% confidence interval, 1.41-11.53] and number of the preoperative antiglaucoma medications (P=0.005; 2.29; 1.28 to 4.11) were significant risk factors for failure in the multivariate analysis. Failed trabectome was not associated with trabeculectomy failure (P=0.899). Postoperative complications were similar. CONCLUSIONS: A failed trabectome did not affect the success rate of a subsequent trabeculectomy.
机译：目的：确定失败的trabectome对随后的小梁切除术的结果的影响。患者与方法：一项队列研究，比较了在小梁切除术手术失败后接受小梁切除术的患者（研究）与在初始手术过程中接受小梁切除术的患者相比（对照）。入选标准为开角型青光眼，年龄≥18岁，未接受最大控制的药物治疗的青光眼。排除标准为同期手术和随访少于6个月。结果指标是眼压（IOP），成功率和并发症的发生。失败是发生额外的青光眼手术，视力丧失或IOP> 21 mm Hg，≤5mm Hg或在1个月后连续2次随访低于基线以下<20％。结果：研究组（n = 34）和对照组（n = 42）的平均随访时间分别为15.4个月和18.6个月。研究组的IOP从基线时的27.6±11.8 mm Hg降至2年时的10.6±2.6 mm Hg，对照组则从29.2±11.4 mm Hg降低至11.0±5.4 mm Hg。研究组和对照组在2年时的成功率分别为60.2％和55.5％（P = 0.895）。全身性高血压[P = 0.009;调整后的危险比4.03;在多变量分析中，重要的危险因素是[95％置信区间[1.41-11.53]和术前使用抗青光眼药物的数量（P = 0.005; 2.29; 1.28至4.11）。失败的trabectome与小梁切除术失败无关（P = 0.899）。术后并发症相似。结论：小梁切除术失败并不影响随后的小梁切除术的成功率。

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