Refusal of Trabeculectomy for the Fellow Eye in Collaborative Initial Glaucoma Treatment Study (CIGTS) Participants.
Refusal of Trabeculectomy for the Fellow Eye in Collaborative Initial Glaucoma Treatment Study (CIGTS) Participants.
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DOI：
10.1016/j.ajo.2016.03.016
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发表时间：
2016-06
影响因子：
4.2
通讯作者：
Chen PP
中科院分区：
文献类型：
--
作者：
Gupta D;Musch DC;Niziol LM;Chen PP
目的了解青光眼小梁切除术后拒绝对侧眼手术治疗的原因。多中心随机临床试验中收集数据的事后分析。对来自青光眼初始治疗合作研究（CIGTS）参与者的数据进行分析，这些参与者被随机分配到研究眼并接受初始小梁切除术，并且其对侧眼符合手术治疗条件。在接受或拒绝对侧眼小梁切除术的两组之间，对参与者的人口统计学数据和特征、研究眼的手术数据以及生活质量调查结果进行比较。主要的结局指标是患者拒绝青光眼的其他眼科手术。在159名随机接受研究眼小梁切除术且对侧眼符合手术条件的受试者中，30名（19%）拒绝对侧眼手术。拒绝对侧眼小梁切除术的患者与接受对侧眼小梁切除术的患者在视觉功能或局部眼部症状方面无显著差异（均p>0.05）。在一项多变量数据分析中，术前对侧眼眼压（IOP）升高与手术风险降低相关。（OR=0.89，p=0.0188），术后3个月的研究眼张力减退与增加的风险相关（OR=7.24，p=0.0125），氩气缝线松解术与手术拒绝的几率降低（OR=0.38，p=0.0385）相关。在CIGTS中，拒绝对侧眼手术并不罕见。那些拒绝对侧眼手术的患者对侧眼IOP较低，并且在研究眼小梁切除术后更有可能出现低眼压。
To understand the reasons for refusal of fellow eye surgical treatment for glaucoma after first eye trabeculectomy. Post-hoc analysis of data collected in a multicenter, randomized clinical trial. Data from participants in the Collaborative Initial Glaucoma Treatment Study (CIGTS) who were randomized to and underwent initial trabeculectomy on their study eye, and whose fellow eye was eligible for surgical treatment was analyzed. Participant demographic data and characteristics, surgical data from the study eye, and quality of life survey results were compared between groups that received or refused trabeculectomy in their fellow eye. The main outcome measure was patient refusal of fellow eye surgery for glaucoma. Of 159 participants who were randomized to and underwent trabeculectomy on their study eye and had a fellow eye that was eligible for surgery, 30 (19%) refused fellow eye surgery. Eligible patients who refused fellow eye trabeculectomy did not differ significantly in visual function or local eye symptoms from those that underwent fellow eye trabeculectomy (all p>0.05). In a multivariable analysis of data, increased fellow eye pre-operative intraocular pressure (IOP) was associated with decreased odds (OR=0.89, p=0.0188), study eye hypotony at three months post-operative was associated with increased odds (OR=7.24, p=0.0125), and argon suture lysis procedures was associated with decreased odds (OR=0.38, p=0.0385) of surgery refusal. Refusal of fellow eye surgery was not uncommonly encountered in the CIGTS. Those who refused fellow eye surgery had lower fellow eye IOP, and were more likely to have had hypotony after study eye trabeculectomy.