24-Hour intraocular pressure control with maximum medical therapy compared with surgery in patients with advanced open-angle glaucoma
24-Hour intraocular pressure control with maximum medical therapy compared with surgery in patients with advanced open-angle glaucoma
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DOI：
10.1016/j.ophtha.2006.01.029
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发表时间：
2006-05-01
期刊：
影响因子：
13.7
通讯作者：
Stewart, WC
中科院分区：
文献类型：
--
作者：
Konstas, AGP;Topouzis, F;Stewart, WC
目的：本研究的目的是评价小梁切除术和丝裂霉素C与最大耐受药物治疗对中重度开角型青光眼患者24小时眼内压（IOP）控制的影响。设计：前瞻性观察研究。参与者：30例手术患者和30例药物治疗的晚期青光眼患者。方法：入组接受初始小梁切除术成功治疗的患者或接受最大耐受药物治疗（2-4种药物）成功治疗的患者。我们在上午6点、上午10点、下午2点、下午6点、下午10点和凌晨2点进行了IOP测量。患者在上午10点的眼压为+/- 1 mmHg进行匹配。主要结果测量：24小时眼压控制。结果：手术患者的平均昼夜眼压为12.1 +/- 2.2，而匹配的药物治疗患者的平均昼夜眼压为13.5 +/- 2.0 mmHg（P = 0.0001）。手术组的平均最大IOP为13.4 ± 2.3 mm Hg，药物组为16.3 ± 3.2 mm Hg（P < 0.0001）。手术组的24小时IOP范围为2.3 ± 0.8 mmHg，药物组为4.8 ± 2.3 mmHg（P < 0.0001）。除上午10点（P = 0.5）外，手术组在每个测量时间点的IOP均具有统计学意义上的较低。药物治疗组中有11名（37%）患者的峰值IOP>= 18 mmHg，手术治疗组中无患者。大多数的峰值IOP（10 11）发生在正常的办公hours.Conclusions：这项研究表明，一个功能良好的小梁切除术提供了一个统计学上较低的平均值，峰值，和范围内的眼压为24小时的一天比最大耐受的药物治疗晚期青光眼患者。
Purpose: The purpose of this study was to evaluate 24-hour intraocular pressure (IOP) control in patients with moderate to severe open-angle glaucoma treated by trabeculectomy and mitomycin C versus maximum tolerated medical therapy.Design: Prospective observational study.Participants: Thirty surgical patients and 30 medically treated patients with advanced glaucoma.Methods: Patients successfully treated with initial trabeculectomy or patients considered successfully treated on maximum tolerated medical therapy (2-4 medicines) were enrolled. We performed IOP measurements at 6 AM, 10 AM, 2 Pm, 6 Pm, 10 Pm, and 2 AM. Patients were matched by IOP +/- 1 mmHg at 10 AM.Main Outcome Measures: A 24-hour IOP control.Results: The surgical patients had a mean diurnal IOP of 12.1 +/- 2.2 versus 13.5 +/- 2.0 mmHg for the matched medically treated patients (P = 0.0001). The average maximum IOP for the surgical group was 13.4 +/- 2.3 and 16.3 +/- 3.2 mm Hg for the medical group (P < 0.0001). The 24-hour range of IOP for the surgical group was 2.3 +/- 0.8 and 4.8 +/- 2.3 mmHg for the medical group (P < 0.0001). Except at 10 AM (P = 0.5), the surgical group had a statistically lower IOP at each measured time point. Eleven (37%) patients in the medically treated group, and none in the surgically treated group, had peak IOPs >= 18 mmHg. The majority of peak IOPs (10 of 11) occurred outside of normal office hours.Conclusions: This study suggests that a well-functioning trabeculectomy provides a statistically lower mean, peak, and range of IOP for the 24-hour day than maximum tolerated medical therapy in advanced glaucoma patients.