Two-year outcomes of combined surgical peripheral iridectomy, goniosynechialysis, and goniotomy for advanced primary angle-closure glaucoma without cataract: A multicenter study.

IF 3.7 3区 医学 Q1 OPHTHALMOLOGY
Fengbin Lin, Liu Li, Ping Lu, Li Tang, Yao Zhang, Lin Xie, Xiaomin Zhu, Guangxian Tang, Hengli Zhang, Lan Lu, Meichun Xiao, Jiangang Xu, Yunhe Song, Yuying Peng, Xiaoyan Li, Weirong Chen, Fengqi Zhou, Ningli Wang, Keith Barton, Ki Ho Park, Tin Aung, Robert N Weinreb, Clement C Tham, Dennis S C Lam, Sujie Fan, Ying Han, Xiulan Zhang
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引用次数: 0

Abstract

Purpose: To evaluate the two-year outcomes of combined surgical peripheral iridectomy (SPI), goniosynechialysis (GSL), and goniotomy (GT) for advanced primary angle-closure glaucoma (PACG) without cataract.

Design: Multicenter prospective study.

Methods: The study included patients who received a combined SPI + GSL + GT for advanced PACG without cataract, all completed a 24-month follow-up. Outcome measures included changes in intraocular pressure (IOP), best-corrected visual acuity (BCVA), use of anti-glaucoma medications, surgical success, and postoperative complications over the 24-month period.

Results: A total of 63 eyes from 51 patients with advanced PACG were included in the study. Among these, 37 eyes (58.7 %) achieved complete success, and 55 eyes (87.3 %) achieved qualified success. The mean IOPs at baseline and after 24 months were 28.8 ± 7.51 mm Hg and 15.8 ± 4.40 mm Hg, respectively (P < 0.001). The average number of anti-glaucoma medications decreased from 1.9 ± 1.4-0.8 ± 1.2 over the 24-month period (P < 0.001). The overall BCVA was stable during the follow-up period (P = 0.225). The primary complications observed included IOP spike (n = 9), hyphema (n = 7), and shallow anterior chamber (n = 3), all of which occurred within the first month postoperatively. Regression analysis showed that older age was positively associated with both complete success [odds ratio (OR) = 1.05; P = 0.030] and qualified success (OR = 1.08; P = 0.024).

Conclusions: SPI + GSL + GT demonstrated safety and effectiveness in treating advanced PACG without cataract over the 24-month study period. This combined surgical approach should be considered a viable alternative to trabeculectomy for these patients.

一项多中心研究:晚期原发性闭角型青光眼无白内障联合手术周围虹膜切除术、性腺协同术和性腺切开术的两年疗效
目的:评价非白内障晚期原发性闭角型青光眼(PACG)联合手术周围虹膜切除术(SPI)、巩膜融合术(GSL)和巩膜切开术(GT)的2年疗效。设计:多中心前瞻性研究。方法:采用SPI + GSL + GT联合治疗无白内障的晚期PACG患者,随访24个月。结果测量包括24个月内眼压(IOP)、最佳矫正视力(BCVA)、抗青光眼药物的使用、手术成功率和术后并发症的变化。结果:51例晚期PACG患者共63只眼纳入研究。其中完全成功37眼(58.7 %),合格成功55眼(87.3% %)。意味着IOPs基线和24个月后28.8 ±7.51   毫米汞柱和15.8±4.40  毫米汞柱,分别(P 结论:SPI + GSL + GT证明安全性和有效性治疗先进PACG在24个月的研究期间没有白内障。对于这些患者,这种联合手术方法应被认为是小梁切除术的可行选择。
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来源期刊
CiteScore
8.10
自引率
18.20%
发文量
197
审稿时长
6 weeks
期刊介绍: The Asia-Pacific Journal of Ophthalmology, a bimonthly, peer-reviewed online scientific publication, is an official publication of the Asia-Pacific Academy of Ophthalmology (APAO), a supranational organization which is committed to research, training, learning, publication and knowledge and skill transfers in ophthalmology and visual sciences. The Asia-Pacific Journal of Ophthalmology welcomes review articles on currently hot topics, original, previously unpublished manuscripts describing clinical investigations, clinical observations and clinically relevant laboratory investigations, as well as .perspectives containing personal viewpoints on topics with broad interests. Editorials are published by invitation only. Case reports are generally not considered. The Asia-Pacific Journal of Ophthalmology covers 16 subspecialties and is freely circulated among individual members of the APAO’s member societies, which amounts to a potential readership of over 50,000.
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