Uneventful Phacoemulsification after Trabeculectomy in Pseudoexfoliation Glaucoma versus Primary Open-Angle Glaucoma.

IF 2 4区 医学 Q2 OPHTHALMOLOGY Ophthalmic Research Pub Date : 2023-01-01 Epub Date: 2023-02-23 DOI:10.1159/000529642
Hatice Tekcan, Mehmet Serhat Mangan, Serhat İmamoglu
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Abstract

Introduction: Conflicting results have been reported on phacoemulsification in the filtered eyes with open-angle glaucoma. In this study, we aim to compare the effect of phacoemulsification after trabeculectomy between pseudoexfoliation glaucoma (XFG) and primary open-angle glaucoma (POAG).

Methods: Consecutive patients with XFG and POAG who underwent uneventful phacoemulsification after trabeculectomy with 5-fluorouracil (TRAB-PHACO group) were reviewed retrospectively and matched to patients who underwent trabeculectomy only (TRAB group). Comparisons were performed for IOP, medication numbers, and success rates. Surgical failure was defined as IOP >21 mm Hg or IOP ≤21 mm Hg with additional medication or glaucoma surgery. Survival analysis was investigated by Kaplan-Meier test and the factors influencing final success by multivariate logistic regression analysis.

Results: The records of 204 patients were reviewed. In XFG, when compared with the baseline, increase in IOP became statistically significant at the at 24-month visit in the TRAB-PHACO group (p = 0.002), at the 6-month visit (p = 0.001) in the TRAB group and remained so throughout the follow-up. In the TRAB-PHACO group, increase of glaucoma medications was statistically significant only at the last visit (p = 0.001) in XFG, at the 6-month visit (p = 0.02) in POAG and remained so throughout the follow-up. Two glaucoma types did not differ statistically from one another in terms of survival analysis. In the TRAB group, the additional glaucoma surgery was more common in XFG compared to POAG (p = 0.02). The trabeculectomy failure after phacoemulsification was related with an IOP spike >25 mm Hg at postoperative first 24h (p = 0.04).

Conclusions: In the filtered eyes with XFG, uneventful phacoemulsification may delay time-related worsening in IOP control and may decrease the additional glaucoma surgery need.

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假剥脱性青光眼与原发性开角型青光眼小梁切除术后不稳定超声乳化。
引言:关于开角型青光眼滤过性白内障超声乳化术的研究结果相互矛盾。在本研究中,我们旨在比较假剥脱性青光眼(XFG)和原发性开角型青光眼(POAG)小梁切除术后超声乳化的效果。方法:回顾性分析连续接受5-氟尿嘧啶小梁切除术后顺利超声乳化的XFG和POAG患者(TRAB-PHACO组),并与仅接受小梁切除手术的患者(TRAB组)进行配对。对眼压、用药次数和成功率进行比较。手术失败被定义为IOP>;21 mm Hg或IOP≤21 mm Hg,并辅以药物治疗或青光眼手术。生存分析采用Kaplan-Meier检验,影响最终成功的因素采用多元逻辑回归分析。结果:对204例患者的病历资料进行了回顾性分析。在XFG中,与基线相比,TRAB-PHACO组在24个月访视时(p=0.002)和TRAB组在6个月访诊时(p=0.001)IOP的增加具有统计学意义,并且在整个随访过程中一直如此。在TRAB-PHACO组中,青光眼药物的增加仅在XFG的最后一次访视(p=0.001)和POAG的6个月访视(p=0.02)具有统计学意义,并且在整个随访过程中一直如此。在生存分析方面,两种青光眼类型在统计学上没有差异。在TRAB组中,与POAG相比,XFG中额外的青光眼手术更常见(p=0.02)。超声乳化后的小梁切除术失败与IOP峰值>;结论:在XFG过滤眼中,平稳的超声乳化可以延缓眼压控制的时间相关恶化,并可以减少额外的青光眼手术需求。
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来源期刊
Ophthalmic Research
Ophthalmic Research 医学-眼科学
CiteScore
3.80
自引率
4.80%
发文量
75
审稿时长
6-12 weeks
期刊介绍: ''Ophthalmic Research'' features original papers and reviews reporting on translational and clinical studies. Authors from throughout the world cover research topics on every field in connection with physical, physiologic, pharmacological, biochemical and molecular biological aspects of ophthalmology. This journal also aims to provide a record of international clinical research for both researchers and clinicians in ophthalmology. Finally, the transfer of information from fundamental research to clinical research and clinical practice is particularly welcome.
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