Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHg

IF 1.8 4区 医学 Q3 OPHTHALMOLOGY Journal of Ophthalmology Pub Date : 2024-01-24 DOI:10.1155/2024/6624021
Shahin Hallaj, Jae-Chiang Wong, Lauren E. Hock, Natasha Nayak Kolomeyer, Aakriti G. Shukla, Michael J. Pro, Marlene R. Moster, Jonathan S. Myers, Reza Razeghinejad, Daniel Lee
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Abstract

Background. This retrospective review reports on patients who underwent glaucoma drainage implant (GDI) surgery and had baseline intraocular pressure (IOP) of ≤18 mmHg with at least one year of follow-up. Methods. Clinical data of 67 eyes of 67 patients were collected from patients’ charts, and the outcomes of GDI were evaluated until 7 years. GDI failure was defined as IOP reduction of less than 20% from the baseline at two consecutive visits three months after surgery, decline to no light perception, or if additional glaucoma surgery was performed. Results. The average age was 65.9 ± 13.2 years. Most cases were male (52.2%), White (53.7%), and had primary open-angle glaucoma (62.7%). Forty-four eyes had prior glaucoma surgery (68.6%) and 46 (68.6%) had severe glaucoma. Though postoperative (postop) IOP changes were insignificant, the average postop number of medications dropped from 2.4 ± 1.4 to 1.9 ± 1.2 medications two years after surgery (). Postop complications (23.9%) included GDI exposure (7.5%), inflammation (4.5%), shallow anterior chamber (4.5%), and strabismus (1.5%). Hypotony was observed in 4 eyes (5.9%), none of which developed hypotony maculopathy. The cumulative one-year failure rate was 56.7%, most of which were due to failure to lower IOP. Conclusion. In patients with baseline IOP ≤18 mmHg who had GDI surgery, though the change in IOP was not statistically significant, the number of medications dropped and visual field progression slowed in a subset of patients with adequate perimetric data. Due to a relatively high rate of complications and limited effectiveness in lowering IOP, GDI should be cautiously used in these eyes.
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术前眼压低于 19 mmHg 眼球的青光眼引流植入物的长期手术效果
背景。本回顾性研究报告的对象是接受青光眼引流植入手术(GDI)且基线眼压(IOP)≤18 mmHg、随访至少一年的患者。研究方法从患者病历中收集了 67 名患者 67 只眼睛的临床数据,并对 GDI 术后 7 年的疗效进行了评估。GDI失败的定义是:术后三个月连续两次就诊时,眼压比基线下降不足20%,光感下降至无光感,或进行了额外的青光眼手术。结果。平均年龄为 65.9 ± 13.2 岁。大多数病例为男性(52.2%)、白人(53.7%)和原发性开角型青光眼(62.7%)。44只眼睛曾接受过青光眼手术(68.6%),46只(68.6%)患有严重青光眼。虽然术后眼压变化不大,但术后两年的平均用药次数从 2.4 ± 1.4 降至 1.9 ± 1.2()。术后并发症(23.9%)包括 GDI 暴露(7.5%)、炎症(4.5%)、前房变浅(4.5%)和斜视(1.5%)。4只眼睛(5.9%)出现了角膜缺损,但没有发生角膜缺损性黄斑病变。一年累计失败率为 56.7%,其中大部分是由于未能降低眼压。结论基线眼压≤18 mmHg的患者接受GDI手术后,虽然眼压的变化在统计学上并不显著,但在有足够周边测量数据的部分患者中,用药次数减少,视野进展减缓。由于并发症发生率相对较高,且降低眼压的效果有限,因此应谨慎在这些眼球中使用 GDI。
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来源期刊
Journal of Ophthalmology
Journal of Ophthalmology MEDICINE, RESEARCH & EXPERIMENTAL-OPHTHALMOLOGY
CiteScore
4.30
自引率
5.30%
发文量
194
审稿时长
6-12 weeks
期刊介绍: Journal of Ophthalmology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the anatomy, physiology and diseases of the eye. Submissions should focus on new diagnostic and surgical techniques, instrument and therapy updates, as well as clinical trials and research findings.
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