A short-term comparison of surgical results between an ab-externo microshunt and trabeculectomy with a main focus on postoperative corneal astigmatism.

IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Japanese Journal of Ophthalmology Pub Date : 2024-09-01 Epub Date: 2024-08-29 DOI:10.1007/s10384-024-01105-y
Hokuto Hamazaki, Ryoko Kaiya, Tadayoshi Kaiya, Shun Hasegawa, Tetsuya Yamamoto
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Abstract

Purpose: To compare surgical results between ab-externo microshunt surgery and trabeculectomy, focusing on postoperative corneal astigmatism.

Study design: Retrospective study.

Methods: Subjects were patients with glaucoma who underwent either standalone ab-externo microshunt surgery or trabeculectomy. Data on ophthalmic examinations obtained preoperatively and 1, 3, and 5 months postoperatively were analyzed. To assess corneal astigmatism, two separate data sets measured by anterior segment optical coherence tomography and autorefractometer were evaluated. Multivariate linear mixed model analyses were conducted to identify factors associated with the astigmatism changes.

Results: Sixty eyes were examined: 13 eyes underwent microshunt surgery, and 47 eyes underwent trabeculectomy. The total corneal astigmatism measurements by anterior segment optical coherence tomography (AS-OCT) were: - 1.15 ± 0.85 D and - 1.17 ± 0.81 D for the microshunt and trabeculectomy groups, respectively, preoperatively. At five months postoperatively they were - 0.92 ± 0.47 D and - 1.61 ± 0.83 D, respectively (P = 0.807 for the microshunt group and P = 0.005 for the trabeculectomy group: Wilcoxon signed-rank test). AS-OCT also indicated similar results for posterior corneal astigmatism. Autorefractometry also found the total corneal astigmatism was significantly changed only in the trabeculectomy group. The linear mixed model analysis revealed that trabeculectomy (P = 0.001), older age (P = 0.004), and longer postoperative period (P = 0.015) were correlated with greater astigmatism changes. The intraocular pressures significantly decreased following both surgical treatments.

Conclusions: Standalone ab-externo microshunt surgery has less effect on corneal astigmatism during a 5 month period than trabeculectomy. Both surgical procedures significantly reduced intraocular pressure.

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腹腔外微分流术与小梁切除术手术效果的短期比较,主要关注术后角膜散光。
目的:比较ab-externo微分流手术和小梁切除术的手术效果,重点关注术后角膜散光:研究设计:回顾性研究:研究对象:青光眼患者,接受独立的ab-externo微分流手术或小梁切除术。分析术前、术后 1、3 和 5 个月的眼科检查数据。为了评估角膜散光,对通过前段光学相干断层扫描和自动折射仪测量的两组独立数据进行了评估。进行了多变量线性混合模型分析,以确定与散光变化相关的因素:结果:共检查了 60 只眼睛:结果:60 只眼睛接受了检查:13 只眼睛接受了微分流手术,47 只眼睛接受了小梁切除术。前段光学相干断层扫描(AS-OCT)测得的总角膜散光度数为- 微分流手术组和小梁切除术组的术前总散光测量值分别为:1.15 ± 0.85 D 和 - 1.17 ± 0.81 D。术后五个月,这两组的视力分别为 - 0.92 ± 0.47 D 和 - 1.61 ± 0.83 D(微分流术组 P = 0.807,小梁切除术组 P = 0.005):Wilcoxon 符号秩检验)。AS-OCT 也显示了类似的角膜后散光结果。自动折射仪也发现,只有小梁切除术组的总角膜散光发生了显著变化。线性混合模型分析显示,小梁切除术(P = 0.001)、年龄较大(P = 0.004)和术后时间较长(P = 0.015)与散光变化较大有关。两种手术治疗后,眼压均明显下降:结论:与小梁切除术相比,单独的ab-externo微分流手术在5个月内对角膜散光的影响较小。两种手术方法都能明显降低眼压。
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来源期刊
CiteScore
4.80
自引率
8.30%
发文量
65
审稿时长
6-12 weeks
期刊介绍: The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication. Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.
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