Efficacy of gonioscopy-assisted transluminal trabeculotomy and trabeculectomy in patients with primary open-angle glaucoma and pseudoexfoliative glaucoma: A single surgeon's experience.

IF 2.1 4区 医学 Q2 OPHTHALMOLOGY Indian Journal of Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-07-11 DOI:10.4103/IJO.IJO_644_24
Ihsan Cakir, Ali Safa Balci, Nese Alagoz, Gülay Yalcinkaya Cakir, Cigdem Altan, Tekin Yasar
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Abstract

Purpose: To compare the intraocular pressure (IOP)-lowering efficiency of gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) with mitomycin C in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG).

Methods: In this retrospective comparative study, consecutive patients with POAG or PEXG who underwent GATT or TRAB by a single surgeon and with a follow-up period of at least 1 year were included. Surgical success rates, change in best-corrected visual acuity, IOP, the need for antiglaucoma medication, surgical complications, and the need for additional glaucoma surgery were compared. Surgical success was defined as an IOP reduction of ≥30% or an IOP of ≤18 mmHg. Complete success was defined as without medication. Qualified success was defined as with or without topical medication.

Results: The mean baseline IOP was 27.4 ± 8.3 and 24.6 ± 7.6 mmHg ( P = 0.13) with the mean number of medications being 3.7 ± 1.0 and 3.7 ± 1.1 ( P = 0.98) in TRAB and GATT, respectively. At 12 months, the mean IOP was 15.3 ± 3.5 and 12.5 ± 4.6 mmHg ( P = 0.24) with the mean number of medications being 0.9 ± 1.2 and 0.8 ± 1.4 ( P = 0.76) after GATT and TRAB, respectively. IOP was lowered from baseline by 52.7% ± 17.5% after TRAB and 45.7% ±18.6% after GATT ( P = 0.12). There was no decrease in best-corrected visual acuity in either group. The qualified surgical success rate was 94.4% in the GATT group and 94.9% in the TRAB group ( P = 0.75). Percentage of complete success was 64.1% and 52.8% ( P = 0.22) after TRAB and GATT, respectively.

Conclusion: In patients with POAG and PEXG, GATT was as effective and safe as TRAB in lowering IOP and reducing the number of antiglaucomatous drugs.

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原发性开角型青光眼和假性角膜外翻性青光眼患者的球镜辅助透镜小梁切开术和小梁切除术的疗效:单个外科医生的经验。
目的:比较原发性开角型青光眼(POAG)和假性角膜外翻性青光眼(PEXG)患者在使用丝裂霉素 C 的情况下接受球镜辅助小梁切开术(GATT)和小梁切除术(TRAB)降低眼压(IOP)的效果:在这项回顾性比较研究中,纳入了由单个外科医生实施 GATT 或 TRAB 并随访至少 1 年的 POAG 或 PEXG 连续患者。比较了手术成功率、最佳矫正视力的变化、眼压、抗青光眼药物的需求、手术并发症以及追加青光眼手术的需求。手术成功的定义是眼压降低≥30%或眼压≤18 mmHg。完全成功的定义是无需用药。有条件的成功定义为使用或不使用局部药物:TRAB 和 GATT 的平均基线眼压分别为 27.4 ± 8.3 和 24.6 ± 7.6 mmHg(P = 0.13),平均用药次数分别为 3.7 ± 1.0 和 3.7 ± 1.1(P = 0.98)。12 个月后,GATT 和 TRAB 的平均眼压分别为 15.3 ± 3.5 和 12.5 ± 4.6 mmHg(P = 0.24),平均用药次数分别为 0.9 ± 1.2 和 0.8 ± 1.4(P = 0.76)。TRAB 治疗后,眼压比基线降低了 52.7% ± 17.5%,GATT 治疗后降低了 45.7% ± 18.6%(P = 0.12)。两组的最佳矫正视力均无下降。GATT 组的合格手术成功率为 94.4%,TRAB 组为 94.9%(P = 0.75)。TRAB组和GATT组的完全成功率分别为64.1%和52.8%(P = 0.22):结论:对于 POAG 和 PEXG 患者,GATT 在降低眼压和减少抗青光眼药物用量方面与 TRAB 一样有效、安全。
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来源期刊
CiteScore
3.80
自引率
19.40%
发文量
1963
审稿时长
38 weeks
期刊介绍: Indian Journal of Ophthalmology covers clinical, experimental, basic science research and translational research studies related to medical, ethical and social issues in field of ophthalmology and vision science. Articles with clinical interest and implications will be given preference.
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