葡萄膜性青光眼的超声乳化术与内环光凝术或 Ab-Interno 光导管成形术(带或不带小梁切开术)。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Helena Lam, Nathaniel P Miller, Joshua H Olson, Justin J Yamanuha
{"title":"葡萄膜性青光眼的超声乳化术与内环光凝术或 Ab-Interno 光导管成形术(带或不带小梁切开术)。","authors":"Helena Lam, Nathaniel P Miller, Joshua H Olson, Justin J Yamanuha","doi":"10.1080/08820538.2024.2405730","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Understanding the current role and efficacy of endocyclophotocoagulation (ECP) compared to ab-interno canaloplasty with or without trabeculotomy (OMNI), combined with cataract extraction and lens implantation (CEIOL), for the management of uveitic glaucoma (UG) is limited.</p><p><strong>Methods: </strong>All UG patients ≥18 years old with ≥6 months of follow-up data (15.2 ± 5.9 months) after CEIOL combined with either ECP or OMNI from August 2019 to May 2022 at a single academic center were retrospectively reviewed [22 eyes of 15 patients (8 ECP, 14 OMNI)]. Surgical success was considered intraocular pressure (IOP) ≤21 mmHg and a reduction of baseline by ≥20% for two consecutive final visits without hypotony, additional surgery, or loss of light perception. Uveitic control was considered a <2-step increase in anterior chamber (AC) cell grade, <3+ AC cell grade, and no increase in steroid drop use at 3 months postoperatively. Secondary outcome measurements included postoperative change in IOP, glaucoma medications, best corrected visual acuity (VA), AC cell grade, and steroid drop frequency.</p><p><strong>Results: </strong>Baseline ocular and preoperative characteristics of eyes (age, sex, laterality, uveitic location, systemic immunomodulating therapy, visual acuity, IOP, number of glaucoma medications, AC cell grade, and steroid drop frequency) did not significantly differ except for greater racial diversity in the ECP group. 62.5% eyes were surgically successful in the ECP group and 85.71% in the OMNI. Between-group analysis showed greater IOP reduction in the OMNI group (<i>p</i> < .05), but no difference in reduction of glaucoma medications (<i>p</i> = .33). No eyes displayed a two-step increase in or >3+ AC cell grade, however, 50% and 64.29%, respectively, increased steroid drop use. Between groups, no difference in the change of AC cell grade (<i>p</i> = .98) or steroid drop use (<i>p</i> = .84) was seen.</p><p><strong>Conclusions: </strong>Both interventions improved visual acuity, IOP, and glaucoma medication use, however, OMNI was more successful at reducing IOP long term. An increase in steroid drop frequency may be the cost of a prolonged post-surgical inflammatory course related to underlying uveitis regardless of surgical approach.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Phacoemulsification with Either Endocyclophotocoagulation or Ab-Interno Canaloplasty with or without Trabeculotomy in Uveitic Glaucoma.\",\"authors\":\"Helena Lam, Nathaniel P Miller, Joshua H Olson, Justin J Yamanuha\",\"doi\":\"10.1080/08820538.2024.2405730\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Understanding the current role and efficacy of endocyclophotocoagulation (ECP) compared to ab-interno canaloplasty with or without trabeculotomy (OMNI), combined with cataract extraction and lens implantation (CEIOL), for the management of uveitic glaucoma (UG) is limited.</p><p><strong>Methods: </strong>All UG patients ≥18 years old with ≥6 months of follow-up data (15.2 ± 5.9 months) after CEIOL combined with either ECP or OMNI from August 2019 to May 2022 at a single academic center were retrospectively reviewed [22 eyes of 15 patients (8 ECP, 14 OMNI)]. Surgical success was considered intraocular pressure (IOP) ≤21 mmHg and a reduction of baseline by ≥20% for two consecutive final visits without hypotony, additional surgery, or loss of light perception. Uveitic control was considered a <2-step increase in anterior chamber (AC) cell grade, <3+ AC cell grade, and no increase in steroid drop use at 3 months postoperatively. Secondary outcome measurements included postoperative change in IOP, glaucoma medications, best corrected visual acuity (VA), AC cell grade, and steroid drop frequency.</p><p><strong>Results: </strong>Baseline ocular and preoperative characteristics of eyes (age, sex, laterality, uveitic location, systemic immunomodulating therapy, visual acuity, IOP, number of glaucoma medications, AC cell grade, and steroid drop frequency) did not significantly differ except for greater racial diversity in the ECP group. 62.5% eyes were surgically successful in the ECP group and 85.71% in the OMNI. Between-group analysis showed greater IOP reduction in the OMNI group (<i>p</i> < .05), but no difference in reduction of glaucoma medications (<i>p</i> = .33). No eyes displayed a two-step increase in or >3+ AC cell grade, however, 50% and 64.29%, respectively, increased steroid drop use. Between groups, no difference in the change of AC cell grade (<i>p</i> = .98) or steroid drop use (<i>p</i> = .84) was seen.</p><p><strong>Conclusions: </strong>Both interventions improved visual acuity, IOP, and glaucoma medication use, however, OMNI was more successful at reducing IOP long term. An increase in steroid drop frequency may be the cost of a prolonged post-surgical inflammatory course related to underlying uveitis regardless of surgical approach.</p>\",\"PeriodicalId\":1,\"journal\":{\"name\":\"Accounts of Chemical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":16.4000,\"publicationDate\":\"2024-09-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Accounts of Chemical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/08820538.2024.2405730\",\"RegionNum\":1,\"RegionCategory\":\"化学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08820538.2024.2405730","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
引用次数: 0

摘要

目的:在葡萄膜炎性青光眼(UG)的治疗中,内巩膜环形光凝术(ECP)与带或不带小梁切开术(OMNI)的眼内巩膜成形术(ab-interno canaloplasty with or without trabeculotomy,OMNI)以及白内障摘除术和晶状体植入术(CEIOL)相比,目前对其作用和疗效的了解有限:方法:回顾性研究了2019年8月至2022年5月期间在一家学术中心接受白内障超声乳化联合白内障摘除术(CEIOL)和白内障超声乳化联合白内障摘除术(ECP)或白内障超声乳化联合人工晶体植入术(OMNI)治疗的所有年龄≥18岁、随访时间≥6个月(15.2 ± 5.9个月)的UG患者[15名患者的22只眼睛(8名ECP患者,14名OMNI患者)]。手术成功被认为是眼压(IOP)≤21 mmHg,且连续两次终末检查基线值降低≥20%,且无眼压过低、无额外手术、无光感丧失。结果:基线眼部特征和术前特征(年龄、性别、侧位、葡萄膜炎位置、全身免疫调节治疗、视力、眼压、青光眼用药次数、AC 细胞分级和类固醇滴注频率)除 ECP 组种族差异较大外,无显著差异。ECP 组中 62.5% 的眼睛手术成功,OMNI 组中 85.71% 的眼睛手术成功。组间分析显示,OMNI 组的眼压降低幅度更大(p p = .33)。没有眼球显示 AC 细胞分级增加两级或 >3+ 级,但分别有 50% 和 64.29% 的眼球增加了类固醇滴眼液的使用。不同组之间,AC细胞等级的变化(p = .98)或类固醇滴眼液的使用(p = .84)均无差异:结论:两种干预措施都能改善视力、眼压和青光眼用药,但 OMNI 在长期降低眼压方面更为成功。无论采用哪种手术方法,类固醇滴注次数的增加可能是与潜在葡萄膜炎相关的术后炎症过程延长的代价。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Phacoemulsification with Either Endocyclophotocoagulation or Ab-Interno Canaloplasty with or without Trabeculotomy in Uveitic Glaucoma.

Purpose: Understanding the current role and efficacy of endocyclophotocoagulation (ECP) compared to ab-interno canaloplasty with or without trabeculotomy (OMNI), combined with cataract extraction and lens implantation (CEIOL), for the management of uveitic glaucoma (UG) is limited.

Methods: All UG patients ≥18 years old with ≥6 months of follow-up data (15.2 ± 5.9 months) after CEIOL combined with either ECP or OMNI from August 2019 to May 2022 at a single academic center were retrospectively reviewed [22 eyes of 15 patients (8 ECP, 14 OMNI)]. Surgical success was considered intraocular pressure (IOP) ≤21 mmHg and a reduction of baseline by ≥20% for two consecutive final visits without hypotony, additional surgery, or loss of light perception. Uveitic control was considered a <2-step increase in anterior chamber (AC) cell grade, <3+ AC cell grade, and no increase in steroid drop use at 3 months postoperatively. Secondary outcome measurements included postoperative change in IOP, glaucoma medications, best corrected visual acuity (VA), AC cell grade, and steroid drop frequency.

Results: Baseline ocular and preoperative characteristics of eyes (age, sex, laterality, uveitic location, systemic immunomodulating therapy, visual acuity, IOP, number of glaucoma medications, AC cell grade, and steroid drop frequency) did not significantly differ except for greater racial diversity in the ECP group. 62.5% eyes were surgically successful in the ECP group and 85.71% in the OMNI. Between-group analysis showed greater IOP reduction in the OMNI group (p < .05), but no difference in reduction of glaucoma medications (p = .33). No eyes displayed a two-step increase in or >3+ AC cell grade, however, 50% and 64.29%, respectively, increased steroid drop use. Between groups, no difference in the change of AC cell grade (p = .98) or steroid drop use (p = .84) was seen.

Conclusions: Both interventions improved visual acuity, IOP, and glaucoma medication use, however, OMNI was more successful at reducing IOP long term. An increase in steroid drop frequency may be the cost of a prolonged post-surgical inflammatory course related to underlying uveitis regardless of surgical approach.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信