Long-term efficacy and safety of posterior endoscopic cyclophotocoagulation in refractory glaucoma: A 5-year follow-up study at a tertiary eye center

IF 3.7 3区 医学 Q1 OPHTHALMOLOGY Asia-Pacific Journal of Ophthalmology Pub Date : 2024-05-01 DOI:10.1016/j.apjo.2024.100074
Yuxin Fang, Pengfei Zheng, Xin Tang, Qiyan Li
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Abstract

Purpose

To evaluate the long-term efficacy of endoscopic cyclophotocoagulation (ECP) via a pars plana approach in a large cohort of refractory glaucoma patients

Design

Single-center, retrospective, longitudinal, cohort study.

Methods

This study recruited patients who underwent ECP and consecutively visited and were followed up for at least 5 years at Beijing Tongren Eye Center, China from January 2013 to December 2017. All patients underwent a complete ophthalmic examination. Treatment success was defined as 6 mmHg ≤ IOP ≤ 21 mmHg with or without anti-glaucoma medications.

Results

A total of 121 eyes of 105 patients including 51 children and 54 adults were enrolled. The mean follow-up was 7.2 ± 1.3 years. The most common glaucoma diagnoses were secondary glaucoma (74 eyes, 61.1 %) and primary congenital glaucoma (19 eyes 15.7 %). The mean extent of the first ECP was 259 degrees. There was an overall decrease in IOP of 38.3 % from 33.3 ± 9.0 mmHg preoperatively to 20.5 ± 7.5 mmHg after surgery, which was statistically significant (P < 0.001). The success rate after 1 or more ECP surgery was 65.3 %. After adjusting for sex, number of prior TCP surgeries and the extent of ECP degree, the failure of ECP was associated with being children (as compared with adults; P = 0.028; OR = 2.549) and higher preoperative IOP (P = 0.001; OR = 1.084).

Conclusion

ECP is an effective procedure for lowing IOP in refractory glaucoma, particularly in patients who are also candidates for vitreoretinal interventions. Hence, a collaborative approach between glaucoma and retinal specialists is of utmost importance in devising an optimal management strategy for glaucoma treatment.

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后内窥镜环形光凝术治疗难治性青光眼的长期疗效和安全性:一家三级眼科中心的五年随访研究
目的评估在一大批难治性青光眼患者中通过旁路进行内镜环形光凝术(ECP)的长期疗效设计单中心、回顾性、纵向、队列研究方法本研究招募了 2013 年 1 月至 2017 年 12 月期间在中国北京同仁眼科中心接受 ECP 治疗并连续就诊和随访至少 5 年的患者。所有患者均接受了全面的眼科检查。无论是否使用抗青光眼药物,治疗成功定义为眼压≤21 mmHg的6 mmHg。平均随访时间为 7.2 ± 1.3 年。最常见的青光眼诊断是继发性青光眼(74 眼,61.1%)和原发性先天性青光眼(19 眼,15.7%)。首次 ECP 的平均范围为 259 度。眼压从术前的 33.3 ± 9.0 mmHg 下降到术后的 20.5 ± 7.5 mmHg,总体下降了 38.3%,具有统计学意义(P < 0.001)。接受过一次或多次 ECP 手术的成功率为 65.3%。结论ECP是一种有效的降低难治性青光眼患者眼压的手术,尤其适用于同时接受玻璃体视网膜介入治疗的患者。因此,青光眼和视网膜专科医生之间的合作对于制定青光眼治疗的最佳管理策略至关重要。
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来源期刊
CiteScore
8.10
自引率
18.20%
发文量
197
审稿时长
6 weeks
期刊介绍: The Asia-Pacific Journal of Ophthalmology, a bimonthly, peer-reviewed online scientific publication, is an official publication of the Asia-Pacific Academy of Ophthalmology (APAO), a supranational organization which is committed to research, training, learning, publication and knowledge and skill transfers in ophthalmology and visual sciences. The Asia-Pacific Journal of Ophthalmology welcomes review articles on currently hot topics, original, previously unpublished manuscripts describing clinical investigations, clinical observations and clinically relevant laboratory investigations, as well as .perspectives containing personal viewpoints on topics with broad interests. Editorials are published by invitation only. Case reports are generally not considered. The Asia-Pacific Journal of Ophthalmology covers 16 subspecialties and is freely circulated among individual members of the APAO’s member societies, which amounts to a potential readership of over 50,000.
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