10-Year Clinical Outcomes of Tube Shunt Surgery at a Tertiary Care Center
10-Year Clinical Outcomes of Tube Shunt Surgery at a Tertiary Care Center
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DOI：
10.1016/j.ajo.2023.04.001
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发表时间：
2023-06-16
影响因子：
4.2
通讯作者：
Wong, Jae-Chiang
中科院分区：
文献类型：
--
作者：
Myers, Jonathan S.;Lamrani, Ryan;Wong, Jae-Chiang
& BULL;目的：报告一家三级保健中心的10年管分流（TS）手术的临床结果。& BULL;设计：回顾性队列研究。& BULL;方法：纳入2005年1月至2011年12月在三级转诊眼科医院接受首次TS手术的眼睛，随访至少10年。收集了人口统计学和临床数据。失败的定义为再次手术降低眼压（IOP），连续两次就诊眼压低于基线的80%，或进展到无光感。& BULL;结果：78例患者85只眼纳入研究组；选取89只眼作为对照组。平均随访时间为11.9 & PLUSMN；1.7年。51例有瓣TS(60%)， 25例无瓣TS(29%)， 9例未知TS（11%）。在最后一次就诊时，平均IOP从29.2 & PLUSMN下降；3.1和PLUSMN上10.4 mmHg；1.2用药至12.6 & PLUSMN；2.2和PLUSMN上5.8 mmHg；1.4 （p < 0.001）。48眼（56%）失败；29只眼（34%）接受了额外的青光眼手术；8只眼（10%）进展为无光知觉；34只眼（40%）也需要TS修复。最佳矫正视力（BCVA） logMAR（最小分辨角）从0.8和PLUSMN下降；0.7（20/125）至1.4 & PLUSMN；最后一次就诊时为1.0 (20/500)（p < 0.001）。平均视野MD为-13.9 & PLUSMN；7.5 dB基线和17.0 & PLUSMN；末次随访时7.0 dB （P= 0.0605）。& BULL;结论：许多眼睛在TS术后10年保持IOP控制，但56%符合失败标准，39%有明显的视力下降，34%接受了额外的手术。结果与TS模型没有差异。[J]中华眼科杂志，2009;22(3):391 - 391。&副本;爱思唯尔公司版权所有。)
& BULL; PURPOSE: To report 10-year clinical outcomes of tube shunt (TS) surgery at a tertiary care center.& BULL; DESIGN: Retrospective cohort study.& BULL; METHODS: Eyes were included that underwent a first TS surgery between January 2005 and December 2011 at a tertiary referral eye hospital and with at least 10 years of follow-up. Demographic and clinical data were collected. Failure was defined as reoperation to lower intraocular pressure (IOP), IOP > 80% of baseline for two consec-utive visits, or progression to no light perception.& BULL; RESULTS: Eighty-five eyes of 78 patients were included in the Study Group; 89 eyes were selected as a Com-parison Group. Mean follow-up was 11.9 & PLUSMN; 1.7 years. Fifty-one valved (60%), 25 non-valved (29%), and nine unknown (11%) TS were placed. At the final visit, mean IOP was reduced from 29.2 & PLUSMN; 10.4 mmHg on 3.1 & PLUSMN; 1.2 medications to 12.6 & PLUSMN; 5.8 mmHg on 2.2 & PLUSMN; 1.4 (p < 0.001 for each). Forty-eight eyes (56%) failed; 29 eyes (34%) underwent additional glaucoma surgery; eight eyes (10%) progressed to no light perception; and 34 eyes (40%) also required TS revision. Best corrected visual acuity (BCVA) logMAR (minimal angle of reso-lution) worsened from 0.8 & PLUSMN; 0.7 (20/125) to 1.4 & PLUSMN; 1.0 (20/500) at the last visit (p < 0.001). Average visual field MD was-13.9 & PLUSMN; 7.5 dB at baseline and-17.0 & PLUSMN; 7.0 dB at last follow-up (P= 0.0605).& BULL; CONCLUSIONS: Many eyes maintained IOP control 10 years following TS, but 56% met failure criteria, 39% had substantial vision loss, and 34% underwent addi-tional surgery. Outcomes did not differ with TS model. (Am J Ophthalmol 2023;253: 132-141. & COPY; 2023 Else-vier Inc. All rights reserved.)