Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHg.
Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHg.
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DOI：
10.1155/2024/6624021
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发表时间：
2024
影响因子：
1.9
通讯作者：
中科院分区：
文献类型：
--
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本回顾性综述报告了接受青光眼引流植入物（GDI）手术且基线眼内压（IOP）≤18 mmHg且至少随访1年的患者。 从患者病历中收集67例67眼的临床资料，并对GDI的结果进行评估，直至7年。GDI失败定义为术后3个月连续两次访视时IOP较基线降低小于20%，下降至无光感，或如果进行了额外的青光眼手术。 平均年龄为65.9 ± 13.2岁。大多数病例为男性（52.2%）、白色（53.7%）和原发性开角型青光眼（62.7%）。44只眼（68.6%）既往接受过青光眼手术，46只眼（68.6%）患有重度青光眼。尽管术后（术后）IOP变化不显著，但术后2年的平均用药次数从2.4 ± 1.4次降至1.9 ± 1.2次（p = 0.0451）。术后并发症（23.9%）包括GDI暴露（7.5%）、炎症（4.5%）、浅前房（4.5%）和斜视（1.5%）。低眼压4眼（5.9%），无低眼压性黄斑病变。一年累积失败率为56.7%，其中大部分是由于未能降低IOP。 在接受GDI手术的基线IOP ≤18 mmHg的患者中，尽管IOP的变化不具有统计学显著性，但在具有足够视野数据的患者亚组中，药物治疗次数减少，视野进展减慢。由于GDI的并发症发生率相对较高，降低IOP的效果有限，因此应谨慎用于这些眼睛。
This retrospective review reports on patients who underwent glaucoma drainage implant (GDI) surgery and had baseline intraocular pressure (IOP) of ≤18 mmHg with at least one year of follow-up. Clinical data of 67 eyes of 67 patients were collected from patients' charts, and the outcomes of GDI were evaluated until 7 years. GDI failure was defined as IOP reduction of less than 20% from the baseline at two consecutive visits three months after surgery, decline to no light perception, or if additional glaucoma surgery was performed. The average age was 65.9 ± 13.2 years. Most cases were male (52.2%), White (53.7%), and had primary open-angle glaucoma (62.7%). Forty-four eyes had prior glaucoma surgery (68.6%) and 46 (68.6%) had severe glaucoma. Though postoperative (postop) IOP changes were insignificant, the average postop number of medications dropped from 2.4 ± 1.4 to 1.9 ± 1.2 medications two years after surgery (p = 0.0451). Postop complications (23.9%) included GDI exposure (7.5%), inflammation (4.5%), shallow anterior chamber (4.5%), and strabismus (1.5%). Hypotony was observed in 4 eyes (5.9%), none of which developed hypotony maculopathy. The cumulative one-year failure rate was 56.7%, most of which were due to failure to lower IOP. In patients with baseline IOP ≤18 mmHg who had GDI surgery, though the change in IOP was not statistically significant, the number of medications dropped and visual field progression slowed in a subset of patients with adequate perimetric data. Due to a relatively high rate of complications and limited effectiveness in lowering IOP, GDI should be cautiously used in these eyes.
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影响因子：
13.7
作者：
Gedde, Steven J.;Feuer, William J.;Brandt, James
通讯作者：
Brandt, James
影响因子：
4.2
作者：
Gedde, Steven J.;Herndon, Leon W.;Brandt, James D.;Budenz, Donald L.;Feuer, William J.;Schiffman, Joyce C.
通讯作者：
Schiffman, Joyce C.
影响因子：
4.2
作者：
Myers, Jonathan S.;Lamrani, Ryan;Wong, Jae-Chiang
通讯作者：
Wong, Jae-Chiang
影响因子：
2.4
作者：
Oie, Shinya;Ishida, Kyoko;Yamamoto, Tetsuya
通讯作者：
Yamamoto, Tetsuya
影响因子：
1.6
作者：
DEJONG, N;GREVE, EL;GEIJSSEN, HC
通讯作者：
GEIJSSEN, HC