Long-term outcomes in Primary congenital glaucoma, aniridia and anterior segment dysgenesis.
Long-term outcomes in Primary congenital glaucoma, aniridia and anterior segment dysgenesis.
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DOI：
10.1177/11206721211073208
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发表时间：
2022-09
影响因子：
1.7
通讯作者：
Yu-Wai-Man, Cynthia
中科院分区：
文献类型：
--
作者：
Magan, Tejal;Tanner, Alexander;Fajardo-Sanchez, Julia;Lim, Kin Sheng;Goyal, Saurabh;Rodrigues, Ian;Amaya, Luis;Trikha, Sameer;Kulkarni, Avinash;Hammond, Christopher;Lascaratos, Gerassimos;Yu-Wai-Man, Cynthia
确定原发性先天性青光眼、无虹膜和前段发育不良的复杂患者队列的长期预后。1990年至2021年间，英国两个高等教育中心：盖伊和圣托马斯NHS基金会信托基金和国王学院医院NHS基金会信托基金进行了回顾性连续研究。我们记录了手术和激光治疗的次数和类型，以及术前和术后的数据，包括眼压（IOP）和抗青光眼药物。21例患者共41只眼。原发性先天性青光眼16眼（39.0%），无虹膜14眼（34.2%），前段发育不良8眼（19.5%）。16只眼（39.0%）接受过一次或多次青光眼手术或激光治疗，长期随访12.8±3.6年。术后3个月（16.5±1.6,p = 0.0067）、6个月（18.7±2.1,p = 0.0386）、12个月（18.6±1.7,p = 0.0229）、3年（14.7±1.2,p = 0.0126）、5年（15.5±1.8,p = 0.0330）、10年（15.4±2.3,p = 0.7780） IOP （mmHg）均较术前（24.1±2.6）显著降低。3个月、6个月、12个月、3年、5年和10年手术成功率（完全和合格）分别为62.5%、50.0%、43.8%、46.2%、45.5%和28.6%。两组患者术后抗青光眼药物使用数量比较，差异无统计学意义（p < 0.05）。4只眼（25.0%）出现术后并发症（水肿、低眼压），经保守处理后消失。这些复杂眼伴晚期青光眼的手术治疗具有挑战性。总体而言，该队列手术效果良好，长期随访后IOP显著下降36.1%。
To determine the long-term outcomes of a cohort of complex patients with primary congenital glaucoma, aniridia and anterior segment dysgenesis. Retrospective consecutive series between 1990–2021 in two UK tertiary centres: Guy's and St Thomas’ NHS Foundation Trust and King's College Hospital NHS Foundation Trust. We recorded the number and types of surgical and laser treatments along with preoperative and postoperative data, including intraocular pressures (IOP) and anti-glaucoma medications. A total of 41 eyes of 21 patients were included. Primary diagnoses were primary congenital glaucoma in 16 eyes (39.0%), aniridia in 14 eyes (34.2%), and anterior segment dysgenesis in 8 eyes (19.5%). Sixteen eyes (39.0%) had one or more glaucoma surgery or laser procedures for advanced glaucoma, and the long-term follow-up was 12.8 ± 3.6 years. There was a significant decrease in postoperative IOP (mmHg) at 3 months (16.5 ± 1.6; p = 0.0067), 6 months (18.7 ± 2.1; p = 0.0386), 12 months (18.6 ± 1.7; p = 0.0229), 3 years (14.7 ± 1.2; p = 0.0126), 5 years (15.5 ± 1.8; p = 0.0330) and 10 years (15.4 ± 2.3; p = 0.7780), compared to preoperatively (24.1 ± 2.6). Surgical success (complete and qualified) was 62.5%, 50.0%, 43.8%, 46.2%, 45.5% and 28.6% at 3 months, 6 months, 12 months, 3 years, 5 years and 10 years, respectively. There was no significant change in the number of anti-glaucoma drugs postoperatively (p > 0.05). Four eyes (25.0%) had postoperative complications (hyphaema, hypotony) that resolved after conservative management. Surgical management of these complex eyes with advanced glaucoma is challenging. Overall, the cohort had good surgical outcomes with a significant decrease in IOP by 36.1% after long-term follow-up.
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