Long-term Visual Acuity Outcomes of Deep Sclerectomy in Pediatric Glaucoma.

IF 2 4区 医学 Q2 OPHTHALMOLOGY
Muhannad I Alkhalifah, Ahmed Mousa, Saleh A Al Obeidan
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Abstract

Prcis: This study provides evidence of the long-term efficacy and safety of Deep Sclerectomy as a successful surgical intervention option in cases with childhood glaucoma.

Objectives: The primary objective was to evaluate the long-term visual acuity outcomes of Deep Sclerectomy in pediatric glaucoma and identify factors predicting poor prognosis. The secondary objective was to evaluate the long-term success rate of Deep Sclerectomy in controlling intraocular pressure.

Methods: A retrospective review was conducted of all pediatric patients who underwent deep sclerectomy at King Abdulaziz University Hospital (KAUH) between 2001 and 2016. We included all patients who had valid visual acuity tests. The preoperative findings and long-term visual and intraocular pressure outcomes were analyzed.

Results: A total of 83 eyes of 68 patients were included. The mean (SD) age of participants was 11.1 (4.0) years (range: 5-25 years). The mean age at surgery was 5.9 months, and the mean follow-up period was 10.75 years. The majority of cases (83.1%) were primary congenital glaucoma. Visual acuity was ≥ 20/40 in 56.6% of cases, ranged between 20/40 and 20/200 in 18.1%, and was ≤ 20/200 in 25.3% of the operated eyes. Complete success rate (IOP ≤ 21 mmHg without medications) after one surgery was achieved in 53 eyes (63.86%). Qualified success rate (IOP ≤ 21 mmHg with medications) was achieved in 8 eyes (9.6%), while 22 eyes (26.5%) failed to achieve target IOP of ≤ 21 mmHg or needed additional surgery to achieve it. Nine eyes (10.74%) had post-operative complications.

Conclusion: Deep sclerectomy is a reasonable option for pediatric glaucoma that can provide good long-term visual outcomes and IOP control with a lower risk of surgical complications.

小儿青光眼深部巩膜切除术的长期视力效果。
目的这项研究为深部巩膜切除术的长期有效性和安全性提供了证据,深部巩膜切除术是治疗儿童青光眼的一种成功的手术干预方案:主要目的是评估深部巩膜切除术对儿童青光眼的长期视力效果,并确定预测不良预后的因素。次要目标是评估深部巩膜切除术在控制眼压方面的长期成功率:我们对2001年至2016年间在阿卜杜勒阿齐兹国王大学医院(KAUH)接受深部巩膜切除术的所有儿科患者进行了回顾性研究。我们纳入了所有接受过有效视力测试的患者。我们对术前检查结果、长期视力和眼压结果进行了分析:结果:共纳入了 68 名患者的 83 只眼睛。参与者的平均(标清)年龄为 11.1(4.0)岁(范围:5-25 岁)。手术时的平均年龄为 5.9 个月,平均随访时间为 10.75 年。大多数病例(83.1%)为原发性先天性青光眼。56.6%的患者视力≥20/40,18.1%的患者视力介于20/40和20/200之间,25.3%的患者视力≤20/200。53只眼睛(63.86%)在一次手术后达到完全成功率(无需药物治疗,眼压≤21 mmHg)。8只眼睛(9.6%)达到了合格成功率(使用药物治疗后眼压≤21 mmHg),22只眼睛(26.5%)未能达到目标眼压≤21 mmHg或需要再次手术才能达到目标眼压。9眼(10.74%)出现术后并发症:结论:深部巩膜切除术是治疗小儿青光眼的合理选择,可提供良好的长期视觉效果和眼压控制,手术并发症风险较低。
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来源期刊
Journal of Glaucoma
Journal of Glaucoma 医学-眼科学
CiteScore
4.20
自引率
10.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Glaucoma is a peer reviewed journal addressing the spectrum of issues affecting definition, diagnosis, and management of glaucoma and providing a forum for lively and stimulating discussion of clinical, scientific, and socioeconomic factors affecting care of glaucoma patients.
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