Perioperative complications of trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS)
Perioperative complications of trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS)
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DOI：
10.1016/j.ajo.2005.02.013
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发表时间：
2005-07-01
影响因子：
4.2
通讯作者：
Guire, KE
中科院分区：
文献类型：
--
作者：
Jampel, HD;Musch, DC;Guire, KE
目得：描述的发病率，和危险因素，手术并发症的报告过程中和术后第一个月内小梁切除术后的合作初始青光眼治疗研究（CIGTS）设计：回顾前瞻性收集的数据，从一个多中心，随机临床试验。方法：并发症制表为300 CIGTS患者随机手术。Logistic回归分析用于确定并发症的危险因素。结果：在300例随机接受初次手术的患者中，共进行了465例小梁切除术。55只眼（12%）报告了术中并发症。最常见的并发症是术中前房出血（37只眼，8%）和结膜钮孔（5只眼，1%）。232只眼（50%）报告了术后早期并发症。并发症发生率超过10%的有浅前房或扁平前房62眼（13%），包裹性滤过泡56眼（12%），上睑下垂55眼（12%），浆液性脉络膜脱离52眼（11%），前房出血或前房积血48眼（10%）。有3例局限性脉络膜上腔出血（0.7%），无眼内炎病例。老年患者更可能发生浆液性脉络膜脱离、新发前或后粘连和伤口渗漏。黑人不太可能经历前房出血，但更可能经历术后上睑下垂。出现双边并发症的受试者的数量高于这将是预测的机会along.CONCLUSIONS：在围手术期的短暂性和自我，限制并发症的发生率很高，但我们观察到很少的并发症，有可能导致严重的持续视力丧失，在这组以前未经治疗的眼睛。
PURPOSE: To describe the incidence of, and risk factors for, surgical complications reported during and within the first post-operative month after trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS).DESIGN: Review of prospectively collected data from a multicenter, randomized clinical trial.METHODS: Complications were tabulated for the 300 CIGTS patients randomized to surgery. Logistic regression analyses were used to identify risk factors for complications.RESULTS: Among the 300 patients randomized to initial surgery, 465 trabeculectomies were performed. Intraoperative complications were reported in 55 eyes (12%). The most frequent reported complications were anterior chamber bleeding during surgery (37 eyes, 8%) and conjunctival buttonhole (five eyes, 1%). Early postoperative complications were reported in 232 eyes (50%). Complications with a frequency over 10% included shallow or flat anterior chamber (62 eyes, 13%), encapsulated bleb (56 eyes, 12%), ptosis (55 eyes, 12%), serous choroidal detachment (52 eyes, 11 %), and anterior chamber bleeding or hyphema (48 eyes, 10%). There were three localized suprachoroidal hemorrhages (0.7%) and no cases of endophthalmitis. Older patients were more likely to experience serous choroidal detachment, new anterior or posterior synechiae, and wound leak. Blacks were less likely to experience anterior chamber bleeding, but more likely to experience postoperative ptosis. The number of subjects experiencing bilateral complications was higher than that which would have been predicted by chance alone.CONCLUSIONS: The incidence of transient and self, limiting complications was high in the perioperative period, but we observed few complications with the potential to cause severe sustained vision loss in this group of previously untreated eyes.