Leopoldo Magacho, Francisco E Lima, Marcos P Ávila
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引用次数: 1
Abstract
Aim: To identify the ideal treatment protocol and success predictors for double-session micropulse transscleral (MP3) laser for glaucoma management.
Materials and methods: Patients who underwent double-session MP3, with a minimum follow-up of 6 months, were retrospectively investigated. Logistic regression analysis was used to verify preoperative success predictors. The following comparisons were made: (1) Between eyes that obtained surgical success vs failure, (2) According to the time required for MP3, and (3) Considering only eyes that required retreatment.
Results: A total of 191 eyes from 148 patients were included. The preoperative intraocular pressure (IOP) was significantly higher than at last follow-up visit (27.3 ± 6.9 vs 14.6 ± 6.0 mm Hg, p < 0.001). Success was observed in 90.5% of the eyes. On logistic regression analysis with preoperative IOP and MP3 time as independent variables, only previous IOP was identified as a statistically significant factor (p = 0.004), with lower IOP relating to higher success. Eyes that required lower MP3 time underwent more MP3 procedures than those with higher MP3 time (1.2 ± 0.5 vs 1.1 ± 0.3, p = 0.03). In the 36 eyes that underwent retreatment, preoperative IOP was higher (31.6 ± 7.4 vs 26.3 ± 6.4 mm Hg, p < 0.001); eyes with successful IOP treatment had a higher MP3 treatment time at the first surgery than eyes with failed IOP correction (364.1 ± 68.2 vs 330.0 ± 18.0 seconds, p = 0.02).
Conclusion: Thus, an ideal double-session MP3 protocol should use a high laser energy at the first surgery, and a high preoperative IOP can be considered as a predictor of surgical failure.
Clinical significance: This is the first study to give special attention to the double-session MP3 protocol and success predictors.
How to cite this article: Magacho L, Lima FE, Ávila MP. Estimating the Ideal Treatment Protocol and Success Predictors for Double-session Micropulse Transscleral Laser for Glaucoma Management. J Curr Glaucoma Pract 2022;16(2):111-116.
目的:探讨双期经巩膜微脉冲激光治疗青光眼的理想治疗方案及成功预测因素。材料与方法:回顾性研究双期MP3患者，随访时间至少6个月。采用Logistic回归分析验证术前成功预测因子。进行以下比较:(1)手术成功与失败的眼睛，(2)根据MP3所需的时间，(3)只考虑需要再治疗的眼睛。结果:共纳入148例患者191只眼。术前眼压(IOP)明显高于末次随访(27.3±6.9 vs 14.6±6.0 mm Hg, p < 0.001)。成功率为90.5%。在术前IOP和MP3时间为自变量的logistic回归分析中，只有既往IOP是有统计学意义的因素(p = 0.004)， IOP越低成功率越高。需要较低MP3时间的眼睛比需要较高MP3时间的眼睛进行了更多的MP3手术(1.2±0.5 vs 1.1±0.3,p = 0.03)。36只复诊眼术前IOP较高(31.6±7.4 vs 26.3±6.4 mm Hg, p < 0.001);IOP矫正成功眼的首次手术MP3治疗时间高于IOP矫正失败眼(364.1±68.2 vs 330.0±18.0秒，p = 0.02)。结论:理想的双段式MP3方案应在首次手术时使用高激光能量，术前高眼压可作为手术失败的预测指标。临床意义:这是第一个特别关注双会话MP3协议和成功预测因素的研究。如何引用本文:Magacho L, Lima FE， Ávila MP。评估双期微脉冲经巩膜激光治疗青光眼的理想治疗方案和成功预测因素。中华青光眼杂志(英文版);2009;16(2):391 - 391。
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