Association of the prolonged use of anti-glaucoma medications with the surgical failure of ab interno microhook trabeculotomy
Association of the prolonged use of anti-glaucoma medications with the surgical failure of ab interno microhook trabeculotomy
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DOI：
10.1111/aos.15090
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发表时间：
2022-01-26
影响因子：
3.4
通讯作者：
Nakamura, Makoto
中科院分区：
文献类型：
--
作者：
Okuda, Mina;Mori, Sotaro;Nakamura, Makoto
目的本研究探讨影响ab interno microhook小梁切开术（mu TLO）手术成功的围手术期因素。方法回顾性研究共纳入146例接受mu TLO的连续患者。我们通过将1年时的手术成功率作为客观变量进行了考克斯比例风险建模。解释变量包括年龄、性别、青光眼类型、术前眼内压（IOP）、青光眼药物评分、Humphrey视野检查的平均偏差（MD）、青光眼药物使用时间、抗血栓药物使用、联合白内障手术、切口范围和糖尿病。此外，我们使用倾向评分分析进行了1：1匹配，并比较了青光眼药物使用持续时间≥ 4.5年（各50例患者）之间的围手术期参数。我们将手术成功定义为满足所有三个标准：IOP 5-21 mmHg，IOP从术前IOP降低≥ 20%，并且没有额外的青光眼手术。结果考克斯比例风险模型显示，抗青光眼药物治疗时间较长与手术失败显著相关。倾向评分匹配分析显示，= 4.5年的用户（72%对52%; p = 0.04）。结论多种青光眼药物的长期使用至少在术后1年对mu TLO的结局产生不利影响。
Purpose This study examined the perioperative factors affecting surgical success in ab interno microhook trabeculotomy (mu TLO). Methods A total of 146 consecutive patients who underwent mu TLO were included in this retrospective study. We performed Cox proportional hazard modelling by setting surgical success at 1 year as an objective variable. The explanatory variables included age, sex, glaucoma type, preoperative intraocular pressure (IOP), glaucoma drug score, mean deviation (MD) of the Humphrey visual field test, duration of glaucoma drug use, antithrombotic drug use, combined cataract surgery, incision range and diabetes mellitus. Additionally, we performed 1:1 matching using propensity score analysis and compared the perioperative parameters between durations of glaucoma drug use of = 4.5 years (50 patients each). We defined surgical success as satisfaction of all three criteria: IOP 5-21 mmHg, IOP reduction of >= 20% from the preoperative IOP and no additional glaucoma surgery. Results The Cox proportional hazard model revealed that a longer duration of anti-glaucoma medication was significantly associated with surgical failure. Propensity score matching analysis showed that the = 4.5-year users (72% versus 52%; p = 0.04). Conclusions The prolonged use of multiple glaucoma drugs adversely affected the outcome of mu TLO at least at 1 year postoperatively.