Success Rates of Trabeculotomy for Steroid-Induced Glaucoma: A Comparative, Multicenter, Retrospective Cohort Study
Success Rates of Trabeculotomy for Steroid-Induced Glaucoma: A Comparative, Multicenter, Retrospective Cohort Study
复制标题
DOI：
10.1016/j.ajo.2010.11.028
复制
发表时间：
2011-06-01
影响因子：
4.2
通讯作者：
Tanihara, Hidenobu
中科院分区：
文献类型：
--
作者：
Iwao, Keiichiro;Inatani, Masaru;Tanihara, Hidenobu
目的：评价小梁切开术治疗类固醇性青光眼的手术效果。设计：多中心、回顾性队列研究。方法：在17个日本临床中心，回顾了1997年至2006年间接受小梁切开术的121例类固醇性青光眼患者。手术失败的定义是需要进行额外的青光眼手术，视力恶化到无光感，或眼压>= 21 mm Hg（标准A）和>= 18 mm Hg（标准B）。我们比较了108例原发性开角型青光眼（POAG）患者行小梁切除术和42例激素性青光眼患者行小梁切除术的手术结果。使用Cox比例风险模型评估失败的预后因素。结果：激素性青光眼小梁切开术与POAG小梁切开术的3年成功率分别为A标准的78.1%和55.8% (P = 0.0008)， B标准的56.4%和30.6% （P < 0.0001）。3年时，激素性青光眼小梁切开术的成功率与A标准的激素性青光眼小梁切除术的成功率相当（83.8%,P = 0.3636），但B标准的成功率较低（71.6%,P = 0.0352）。激素性青光眼小梁切开术失败的预后因素为既往玻璃体切开术（相对危险度[RR] = 5.340；标准A P = 0.0452，标准B P = 3.898；标准B P = 0.0360）和非眼液注入使用皮质类固醇（RR = 2.752；标准B P = 0.0352）。结论：小梁切开术可有效控制眼压
PURPOSE: To evaluate the surgical outcomes of trabeculotomy for steroid-induced glaucoma.DESIGN: Multicenter, retrospective cohort study.METHODS: At 17 Japanese clinical centers, 121 steroid-induced glaucoma patients who underwent trabeculotomy between 1997 and 2006 were reviewed. Surgical failure was defined by the need for additional glaucoma surgery, deterioration of visual acuity to no light perception, or intraocular pressure >= 21 mm Hg (criterion A) and >= 18 mm Hg (criterion B). Surgical outcomes were compared with those of 108 primary open-angle glaucoma (POAG) patients who underwent trabeculotomy and 42 steroid-induced glaucoma patients who underwent trabeculectomy. Prognostic factors for failure were evaluated using the Cox proportional hazards model.RESULTS: The probabilities of success at 3 years for trabeculotomy for steroid-induced glaucoma vs trabeculotomy for POAG was 78.1% vs 55.8% for criterion A (P = .0008) and 56.4% vs 30.6% for criterion B (P < .0001), respectively. At 3 years, the success of trabeculotomy for steroid-induced glaucoma was comparable to trabeculectomy for steroid-induced glaucoma for criterion A (83.8%; P = .3636), but lower for criterion B (71.6%; P = .0352). Prognostic factors for failure of trabeculotomy for steroid-induced glaucoma were previous vitrectomy (relative risk [RR] = 5.340; P = .0452 on criterion A, RR = 3.898; P = .0360 for criterion B) and corticosteroid administration other than ocular instillation (RR = 2.752; P = .0352 for criterion B).CONCLUSIONS: Trabeculotomy is effective for controlling intraocular pressure