Risk factors for intraocular pressure elevation in a six-month period after ab interno trabeculotomy using a Kahook Dual Blade.
Risk factors for intraocular pressure elevation in a six-month period after ab interno trabeculotomy using a Kahook Dual Blade.
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DOI：
10.1186/s12886-022-02545-1
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发表时间：
2022-07-30
影响因子：
2
通讯作者：
Inoue, Toshihiro
中科院分区：
文献类型：
--
作者：
Murakami-Kojima, Setsu;Takahashi, Eri;Eguchi-Matsumoto, Momoka;Saruwatari, Junji;Nakashima, Kei-ichi;Inoue, Toshihiro
关键词：
目的：探讨使用KaHook双刀片小梁切开术(KDB小梁切开术)术后早期眼压升高的危险因素。对在熊本大学医院行KDB小梁切开术的剥脱性青光眼(EXG)76眼和原发性开角型青光眼(POAG)56眼进行了回顾性研究。术后高眼压分为眼压≥20 mm Hg(术后3个月内，持续性或暂时性)、一过性眼压≥20 mm Hg(术后眼压≥20 mm Hg，术后降至20 mm Hg以下)和眼压峰值(≥ 10 mm Hg)。危险因素采用Logistic回归分析。EXG组平均眼压为24.98(7.23)mm Hg，POAG组平均为21.28(6.58)mm Hg。术后6个月EXG患者眼压下降32.1%，POAG患者下降17.7%。术后眼压≥为20 mm Hg者占56.6%，POAG者占51.8%。15.8%的EXG患者和14.3%的POAG患者出现眼压峰值。Logistic回归分析显示，年龄(OR = 0.866，95%CI = 0.793~0.945)、术前用药(OR = 2.02，95%CI = 1.17~3.49)、小梁切开术联合白内障手术(OR = 0.0674，95%CI = 0.015~0.303)、术后第1天眼压(OR = 1.41，95%CI = 1.18~1.68)是有意义的危险因素。术后第1天眼压(OR = 1.1，95%CI = 1.03~1.17)与年龄(OR = 0.948，95%CI = 0.901~0.997)和术前眼压(OR MIC0.83，95%CI = 0.736~0.936)有关。虽然KDB小梁切开术是治疗EXG和POAG的有效方法，但术前服用多种药物并在术后第1天出现高眼压的患者需要仔细随访，以防止术后眼压升高。网上版载有补充材料，可在10.1186/s12886-022-02545-1查阅。
To examine the risk factors for an early postoperative intraocular pressure (IOP) increase after ab interno trabeculotomy using a Kahook Dual Blade (KDB trabeculotomy). A retrospective study was performed in 76 exfoliation glaucoma (EXG) eyes and 56 primary open angle glaucoma (POAG) eyes that underwent KDB trabeculotomy, with or without cataract surgery at Kumamoto University Hospital. Postoperative high IOP was classified as IOP≥20 mmHg (within three months after surgery, whether persistent or temporary), transient IOP≥20 mmHg (IOP≥20 mmHg after surgery, then dropped below 20 mmHg), and the presence of IOP spikes (≥ 10 mmHg from baseline). Risk factors were examined using logistic regression analysis. The preoperative mean IOP (SD) was 24.98 (7.23) mmHg in patients with EXG and 21.28 (6.58) mmHg in patients with POAG. IOP was reduced by 32.1% in patients with EXG and by 17.7% in patients with POAG at 6 months after surgery. Postoperative IOP≥20 mmHg was observed in 56.6% of EXG patients and in 51.8% of POAG patients. IOP spikes occurred in 15.8% of EXG patients and in 14.3% of POAG patients. Logistic regression analysis showed that factors with significant odds ratios (ORs) were age (OR = 0.866, 95% CI = 0.793–0.945), preoperative medication use (OR = 2.02, 95% CI = 1.17–3.49), trabeculotomy in combination with cataract surgery (OR = 0.0674, 95% CI = 0.015–0.303), and IOP at day 1 (OR = 1.41, 95% CI = 1.18–1.68) for postoperative IOP≥20 mmHg, the IOP at day 1 (OR = 1.1, 95% CI = 1.03–1.17) for transient IOP≥20 mmHg, and age (OR = 0.948, 95% CI = 0.901–0.997) and preoperative IOP (OR = 0.83, 95% CI = 0.736–0.936) for IOP spikes. Although KDB trabeculotomy is an effective treatment for patients with EXG and POAG, patients who take multiple preoperative medications and have a high IOP on day 1 require careful follow-up to prevent postoperative IOP elevation. The online version contains supplementary material available at 10.1186/s12886-022-02545-1.
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