Impact of glaucoma medications on subsequent Schlemm's canal surgery outcome: Cox proportional hazard model and propensity score-matched analysis

IF 3 3区医学 Q1 OPHTHALMOLOGY

Acta Ophthalmologica Pub Date : 2023-09-12 DOI:10.1111/aos.15750

Mina Okuda-Arai, Sotaro Mori, Fumio Takano, Kaori Ueda, Mari Sakamoto, Yuko Yamada-Nakanishi, Makoto Nakamura

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引用次数: 0

Abstract

Purpose

The impact of various preoperative glaucoma medications on Schlemm's canal surgery outcomes remains unclear. This study aimed to investigate the impact of preoperative glaucoma medications on the postoperative 1-year outcomes of μTLO.

Methods

We analyzed the medical records of 218 patients who underwent their first μTLO to investigate the 1-year postoperative outcomes. Cox proportional hazard regression analysis was performed with surgical failure as the dependent variable and each type of preoperative medication as the independent variable. We also compared the 1-year outcomes of μTLO between users and non-users of specific medications using propensity score matching. Surgical success was defined as a postoperative intraocular pressure ranging from 5 to 21 mmHg, a ≥20% reduction in IOP from baseline, and no additional glaucoma surgery within 1 year postoperatively.

Results

The Cox proportional hazard analysis showed that all drugs that do not increase the conventional outflow exhibited hazard ratios greater than 1.0, and the preoperative use of β-blockers and oral CAI was a significant surgical risk factor (hazard ratio: 2.65 and 2.45, p = 0.04 and <0.001). In the propensity score matching analysis, success rates at 1 year postoperatively were 55/85, 54/79, 60/73, and 40/76% for users/non-users of β-blockers, topical CAIs, an alpha-2 adrenergic agonist, and an oral CAI, respectively. Kaplan–Meier survival curves in these comparisons also demonstrated that preoperative β-blockers and oral CAI use were significant surgical risks (p = 0.01, <0.001).

Conclusion

Our study suggests that preoperative medications that do not involve conventional pathway outflow have a detrimental effect on subsequent Schlemm's canal surgery outcomes.

查看原文本刊更多论文

青光眼药物对后续施莱姆氏管手术结果的影响：Cox比例危险模型和倾向评分匹配分析。

目的：各种术前青光眼药物对 Schlemm's 管手术疗效的影响仍不明确。本研究旨在探讨术前青光眼药物对 μTLO 术后 1 年疗效的影响：我们分析了218名首次接受μTLO的患者的病历，以调查其术后1年的疗效。以手术失败为因变量，以各种术前药物为自变量，进行了 Cox 比例危险回归分析。我们还使用倾向得分匹配法比较了特定药物使用者和非使用者的μTLO术后1年预后。手术成功的定义是：术后眼压在 5 至 21 mmHg 之间，眼压比基线降低≥20%，术后 1 年内未再进行青光眼手术：Cox比例危险分析显示，所有不增加常规流出量的药物的危险比均大于1.0，而术前使用β受体阻滞剂和口服CAI是一个重要的手术危险因素（危险比：2.65和2.45，P = 0.04）：我们的研究表明，不涉及常规途径流出的术前药物对随后的 Schlemm 管手术结果有不利影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.