Mortality following glaucoma surgery in octogenarians with primary open angle glaucoma.

IF 1.4 4区医学 Q3 OPHTHALMOLOGY

International Ophthalmology Pub Date : 2025-09-26 DOI:10.1007/s10792-025-03727-8

Hussain Aluzri, Vanessa Yeo, Kusy Suleiman, Jay Richardson, Velota C T Sung

{"title":"Mortality following glaucoma surgery in octogenarians with primary open angle glaucoma.","authors":"Hussain Aluzri, Vanessa Yeo, Kusy Suleiman, Jay Richardson, Velota C T Sung","doi":"10.1007/s10792-025-03727-8","DOIUrl":null,"url":null,"abstract":"Background: This study aims to quantify the mortality rate following glaucoma surgery in octogenarian patients with primary open-angle glaucoma (POAG) and identify risk factors associated with mortality in this age group.Methods: A retrospective single centre consecutive case series was conducted involving 115 patients aged 80 and over who underwent glaucoma surgery at the Birmingham Midland Eye Centre between January 2015 and December 2019.Results: The all-cause mortality incidence for patients over 80 undergoing glaucoma surgery is 66.86 deaths per 1000 person-years. On univariable analysis, pre-operative risk factors [hazard ratio [HR], 95% Confidence interval (CI)] for increased mortality include age, [1.099 (1.013, 1.192)], Clinical Frailty Score [1.250 (1.036, 1.507)], chronic obstructive pulmonary disease (COPD) [2.187 (1.252, 3.818)], dementia [2.397 (1.075, 5.343)], myocardial infarction [2.392 (1.208, 4.737)], respiratory system disease [1.974, (1.179, 3.305), and solid tumours [7.344 (2.170, 24.849)]. Visual acuity was the only ophthalmic factor significantly associated [1.745 (1.046, 2.902)] with mortality, while other glaucoma-related parameters, such as intraocular pressure and retinal nerve fibre layer thickness, were non-significant. On multi-variable analysis, Afro-Caribbean became significant [0.469 (0.224, 0.979)], and all univariable risk factors remained significant except for clinical frailty score and dementia. In terms of glaucoma surgery, cyclodiode laser is the only operation that had a significant hazard ratio [2.271 (1.083, 4.762)], likely due to selection bias of ill patients.Conclusion: The overall five-year survival rate post-surgery was 72.01%, with a nine-year survival rate of 43.30%. Clinical frailty scale should be assessed for all elderly patients considered for glaucoma surgery. Assessing systemic health in elderly patients is crucial for optimizing surgical outcomes and improving survival.","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"390"},"PeriodicalIF":1.4000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10792-025-03727-8","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: This study aims to quantify the mortality rate following glaucoma surgery in octogenarian patients with primary open-angle glaucoma (POAG) and identify risk factors associated with mortality in this age group.

Methods: A retrospective single centre consecutive case series was conducted involving 115 patients aged 80 and over who underwent glaucoma surgery at the Birmingham Midland Eye Centre between January 2015 and December 2019.

Results: The all-cause mortality incidence for patients over 80 undergoing glaucoma surgery is 66.86 deaths per 1000 person-years. On univariable analysis, pre-operative risk factors [hazard ratio [HR], 95% Confidence interval (CI)] for increased mortality include age, [1.099 (1.013, 1.192)], Clinical Frailty Score [1.250 (1.036, 1.507)], chronic obstructive pulmonary disease (COPD) [2.187 (1.252, 3.818)], dementia [2.397 (1.075, 5.343)], myocardial infarction [2.392 (1.208, 4.737)], respiratory system disease [1.974, (1.179, 3.305), and solid tumours [7.344 (2.170, 24.849)]. Visual acuity was the only ophthalmic factor significantly associated [1.745 (1.046, 2.902)] with mortality, while other glaucoma-related parameters, such as intraocular pressure and retinal nerve fibre layer thickness, were non-significant. On multi-variable analysis, Afro-Caribbean became significant [0.469 (0.224, 0.979)], and all univariable risk factors remained significant except for clinical frailty score and dementia. In terms of glaucoma surgery, cyclodiode laser is the only operation that had a significant hazard ratio [2.271 (1.083, 4.762)], likely due to selection bias of ill patients.

Conclusion: The overall five-year survival rate post-surgery was 72.01%, with a nine-year survival rate of 43.30%. Clinical frailty scale should be assessed for all elderly patients considered for glaucoma surgery. Assessing systemic health in elderly patients is crucial for optimizing surgical outcomes and improving survival.

查看原文本刊更多论文

八十多岁原发性开角型青光眼手术后的死亡率。

背景：本研究旨在量化80多岁原发性开角型青光眼（POAG）患者青光眼手术后的死亡率，并确定与该年龄组死亡率相关的危险因素。方法：对2015年1月至2019年12月期间在伯明翰米德兰眼科中心接受青光眼手术的115例80岁及以上患者进行回顾性单中心连续病例系列研究。结果：80岁以上青光眼手术患者的全因死亡率为66.86 / 1000人年。在单变量分析中，导致死亡率增加的术前危险因素[危险比[HR]、95%可信区间（CI）]包括年龄[1.099(1.013,1.192)]、临床虚弱评分[1.250(1.036,1.507)]、慢性阻塞性肺疾病（COPD）[2.187(1.252, 3.818)]、痴呆[2.397(1.075,5.343)]、心肌梗死[2.392(1.208,4.737)]、呼吸系统疾病[1.974,(1.179,3.305)]、实体肿瘤[7.344(2.170,24.849)]。视力是唯一与死亡率显著相关的眼科因素[1.745(1.046,2.902)]，而其他与青光眼相关的参数，如眼压和视网膜神经纤维层厚度，均无显著性差异。在多变量分析中，非裔加勒比人变得显著[0.469(0.224,0.979)]，除临床虚弱评分和痴呆外，所有单变量危险因素仍然显著。在青光眼手术中，环形二极管激光手术是唯一具有显著危险比的手术[2.271(1.083,4.762)]，这可能是由于患者的选择偏倚。结论：术后总5年生存率为72.01%，9年生存率为43.30%。所有考虑进行青光眼手术的老年患者均应进行临床虚弱量表评估。评估老年患者的全身健康状况对于优化手术效果和提高生存率至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Ophthalmology OPHTHALMOLOGY-

CiteScore

3.20

自引率

0.00%

发文量

451

期刊介绍： International Ophthalmology provides the clinician with articles on all the relevant subspecialties of ophthalmology, with a broad international scope. The emphasis is on presentation of the latest clinical research in the field. In addition, the journal includes regular sections devoted to new developments in technologies, products, and techniques.