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首页> 外文期刊>American Journal of Ophthalmology: The International Journal of Ophthalmology >Clinical results of ab interno trabeculotomy using the trabectome for open-angle glaucoma: The mayo clinic series in Rochester, Minnesota
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Clinical results of ab interno trabeculotomy using the trabectome for open-angle glaucoma: The mayo clinic series in Rochester, Minnesota

机译：使用截肢术治疗开角型青光眼的腹腔镜小梁切除术的临床结果：明尼苏达州罗切斯特市的梅奥诊所系列

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Purpose To determine outcomes of ab interno trabeculotomy for treatment of open-angle glaucoma (OAG). Design Retrospective interventional single-surgeon, single-center case series. Methods Data were collected from 246 patients undergoing ab interno trabeculotomy between September 1, 2006, and December 1, 2010, with 3 months' follow-up or longer. Kaplan-Meier analysis was performed using Criteria A (postoperative intraocular pressure [IOP] ≤21 mm Hg or ≥20% reduction from preoperative IOP) and Criteria B (IOP ≤18 mm Hg and ≥20% reduction in IOP). Failure included increased glaucoma medications or subsequent surgery. Failure risk factors were identified using Cox proportional hazards ratio (HR). Results Of 88 cases of ab interno trabeculotomy-only and 158 cases of ab interno trabeculotomy with cataract extraction, the retention rate was 70% for 1 year and 62% for 2 years. Preoperative mean IOP was 21.6 ± 8.6 mm Hg; the number of glaucoma medications was 3.1 ± 1.1. At 24 months postoperatively, mean IOP was reduced 29% to 15.3 ± 4.6 mm Hg (P < 0.001) and the number of glaucoma medications was reduced 38% to 1.9 ± 1.3 (P < 0.001) with a success rate of 62% (95% CI, 56%-68%) using Criteria A and 22% (95% CI, 16%-29%) using Criteria B. Failure risk factors using Criteria A included primary OAG (HR 3.14, P < 0.01, 95% CI, 1.91-5.17) and past argon laser trabeculoplasty (HR 1.81, P < 0.01, 95% CI, 1.18-2.77). Using Criteria B, the HR for pseudoexfoliative glaucoma was 0.43 (P < 0.01, 95% CI 0.27-0.67). Of the cases, 66 (26.8%) required subsequent surgery on an average of 10 months (2 days to 3.2 years) after ab interno trabeculotomy. Conclusions For criteria involving IOP ≤18 mm Hg, the 24-month survival of ab interno trabeculotomy is low. This surgery is appropriate for patients requiring a target IOP of 21 mm Hg or above.
机译：目的确定腹腔镜小梁切开术治疗开角型青光眼（OAG）的结果。设计回顾性介入式单刀单中心病例系列。方法收集2006年9月1日至2010年12月1日之间进行腹腔镜小梁切除术的246例患者的资料，并随访3个月或更长时间。 Kaplan-Meier分析使用标准A（术后眼内压[IOP]≤21mm Hg或比术前IOP降低≥20％）和标准B（IOP≤18mm Hg且IOP降低≥20％）进行。失败包括增加的青光眼药物治疗或随后的手术。使用Cox比例风险比（HR）识别故障风险因素。结果88例单纯腹腔镜小梁切开术和158例经白内障摘除腹腔镜小梁切开术，保留率分别为1年70％和2年62％。术前平均眼压为21.6±8.6毫米汞柱;青光眼用药数量为3.1±1.1。术后24个月，平均IOP降低29％至15.3±4.6 mm Hg（P <0.001），青光眼用药数量降低38％至1.9±1.3（P <0.001），成功率为62％（95）使用标准A的CI为56％-68％），使用标准B的CI为22％（95％CI，16％-29％）。使用标准A的失败风险因素包括主要OAG（HR 3.14，P <0.01，95％CI （1.91-5.17）和过去的氩激光小梁成形术（HR 1.81，P <0.01，95％CI，1.18-2.77）。使用标准B，假性剥脱性青光眼的HR为0.43（P <0.01，95％CI 0.27-0.67）。在这些病例中，有66例（26.8％）在进行腹腔镜小梁切开术后平均需要10个月（2天至3.2年）进行后续手术。结论对于涉及IOP≤18 mm Hg的标准，腹腔镜小梁切开术的24个月生存期较低。该手术适合要求目标眼压为21 mm Hg或更高的患者。

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