{"title":"超过120°、240°和360°角的切口治疗青少年开角型青光眼的疗效：一项多中心研究。","authors":"Zefeng Yang, Zhixuan Wang, Hanying Fan, Qingshu Ge, Guangfu Dang, Xiao Yang, Lin Xie, Xiaoming Zhu, Yangfan Yang, Yuhong Wang, Jinkun Liu, Hongyang Zhang, Yuhan Feng, Yongjun Qi, Xiangxiang Ye, Mingying Lai, Peijie Lin, Pusheng Wang, Shumei Han, Jiangang Xu, Liming Tao, Heting Liu, Xin Nie, Mengfei Liao, Kai Zou, Yi Jiang, Yunhe Song, Fengbin Lin, Fengqi Zhou, Dilimulati Xiaokaiti, Xiaoyi Liu, Zige Fang, Ling Jin, Yu Chen, Clement C Tham, Ying Han, Xiaojing Pan, Liuzhi Zeng, Robert N Weinreb, Xiulan Zhang","doi":"10.1097/IJG.0000000000002569","DOIUrl":null,"url":null,"abstract":"<p><strong>Prcis: </strong>240-degree and 360-degree goniotomy (GT) demonstrated similar efficacy in intraocular pressure (IOP) reduction, both outperforming 120-degree GT in patients with juvenile open angle glaucoma (JOAG) at postoperative 6-month follow-up.</p><p><strong>Objective: </strong>To compare the surgical efficacy and safety of 120-degree, 240-degree, and 360-degree GT for patients with JOAG.</p><p><strong>Patients and methods: </strong>This multicenter retrospective study included 102 eyes of 102 patients with JOAG, who underwent GT with a follow-up of at least 6 months. Patients were categorized into 3 groups: (1) 120-degree GT, (2) 240-degree GT, and (3) 360-degree GT. IOP, glaucoma medications, and complications were recorded at baseline and the final visit. Complete success and qualified success were defined as a postoperative IOP ≤21 mm Hg without and with medications, respectively.</p><p><strong>Results: </strong>Mean age of the participants was 24.4 ± 7.9 years. After a mean follow-up of 8.1 ± 2.7 months, complete success rates were similar between the 240-degree GT (45.2%) and the 360-degree GT (63.2%; P = 0.135), and both were superior to 120-degree GT (18.2%; P < 0.05). Qualified success rates among patients in the 120-degree, 240-degree, and 360-degree GT groups were 93.9%, 96.8%, and 100%, respectively, and showed no statistically significant difference ( P = 0.292). 360-degree GT required fewer medications than 240-degree GT and 120-degree GT ( P < 0.05), with no significant difference in medications between 120-degree GT and 240-degree GT ( P > 0.05). Hyphema was the most common postoperative complication, with a significantly higher incidence in the 360-degree GT (68.4%) compared with the 240-degree GT (41.9%) and 120-degree GT (33.3%; P < 0.05).</p><p><strong>Conclusions: </strong>240-degree and 360-degree GT showed similar efficacy in IOP reduction and were superior to 120-degree GT. More extensive GT may provide better outcomes in JOAG.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"433-439"},"PeriodicalIF":1.8000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcome of Goniotomy Over 120, 240 and 360 Degrees in Juvenile Open Angle Glaucoma: A Multicenter Study.\",\"authors\":\"Zefeng Yang, Zhixuan Wang, Hanying Fan, Qingshu Ge, Guangfu Dang, Xiao Yang, Lin Xie, Xiaoming Zhu, Yangfan Yang, Yuhong Wang, Jinkun Liu, Hongyang Zhang, Yuhan Feng, Yongjun Qi, Xiangxiang Ye, Mingying Lai, Peijie Lin, Pusheng Wang, Shumei Han, Jiangang Xu, Liming Tao, Heting Liu, Xin Nie, Mengfei Liao, Kai Zou, Yi Jiang, Yunhe Song, Fengbin Lin, Fengqi Zhou, Dilimulati Xiaokaiti, Xiaoyi Liu, Zige Fang, Ling Jin, Yu Chen, Clement C Tham, Ying Han, Xiaojing Pan, Liuzhi Zeng, Robert N Weinreb, Xiulan Zhang\",\"doi\":\"10.1097/IJG.0000000000002569\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Prcis: </strong>240-degree and 360-degree goniotomy (GT) demonstrated similar efficacy in intraocular pressure (IOP) reduction, both outperforming 120-degree GT in patients with juvenile open angle glaucoma (JOAG) at postoperative 6-month follow-up.</p><p><strong>Objective: </strong>To compare the surgical efficacy and safety of 120-degree, 240-degree, and 360-degree GT for patients with JOAG.</p><p><strong>Patients and methods: </strong>This multicenter retrospective study included 102 eyes of 102 patients with JOAG, who underwent GT with a follow-up of at least 6 months. Patients were categorized into 3 groups: (1) 120-degree GT, (2) 240-degree GT, and (3) 360-degree GT. IOP, glaucoma medications, and complications were recorded at baseline and the final visit. Complete success and qualified success were defined as a postoperative IOP ≤21 mm Hg without and with medications, respectively.</p><p><strong>Results: </strong>Mean age of the participants was 24.4 ± 7.9 years. After a mean follow-up of 8.1 ± 2.7 months, complete success rates were similar between the 240-degree GT (45.2%) and the 360-degree GT (63.2%; P = 0.135), and both were superior to 120-degree GT (18.2%; P < 0.05). Qualified success rates among patients in the 120-degree, 240-degree, and 360-degree GT groups were 93.9%, 96.8%, and 100%, respectively, and showed no statistically significant difference ( P = 0.292). 360-degree GT required fewer medications than 240-degree GT and 120-degree GT ( P < 0.05), with no significant difference in medications between 120-degree GT and 240-degree GT ( P > 0.05). Hyphema was the most common postoperative complication, with a significantly higher incidence in the 360-degree GT (68.4%) compared with the 240-degree GT (41.9%) and 120-degree GT (33.3%; P < 0.05).</p><p><strong>Conclusions: </strong>240-degree and 360-degree GT showed similar efficacy in IOP reduction and were superior to 120-degree GT. More extensive GT may provide better outcomes in JOAG.</p>\",\"PeriodicalId\":15938,\"journal\":{\"name\":\"Journal of Glaucoma\",\"volume\":\" \",\"pages\":\"433-439\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Glaucoma\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/IJG.0000000000002569\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/3/20 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Glaucoma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IJG.0000000000002569","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/20 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
实践：240°和360°切角术（GT）在降低眼压方面表现出相似的效果，在术后6个月的随访中，在青少年开角型青光眼（JOAG）患者中均优于120°切角术。目的：比较120度、240度和360度切开术治疗青少年开角型青光眼（JOAG）的手术疗效和安全性。患者和方法：本多中心回顾性研究纳入102例JOAG患者的102只眼，接受GT治疗，随访至少6个月。患者分为三组：(1)120°GT,(2) 240°GT和(3)360°GT。在基线和最后一次访问时记录眼压（IOP）、青光眼药物和并发症。完全成功和合格成功分别定义为术后IOP≤21 mm Hg，不使用药物和使用药物。结果：患者平均年龄24.4±7.9岁。平均随访8.1±2.7个月后，240°GT（45.2%）和360°GT（63.2%）的完全成功率相似（P=0.135），均优于120°GT (18.2%) （P0.05）。积血是最常见的术后并发症，360°GT发生率（68.4%）明显高于240°GT（41.9%）和120°GT（33.3%）。结论：240°和360°GT降低IOP的效果相似，且优于120°GT。更广泛的GT可能为JOAG提供更好的结果。
Outcome of Goniotomy Over 120, 240 and 360 Degrees in Juvenile Open Angle Glaucoma: A Multicenter Study.
Prcis: 240-degree and 360-degree goniotomy (GT) demonstrated similar efficacy in intraocular pressure (IOP) reduction, both outperforming 120-degree GT in patients with juvenile open angle glaucoma (JOAG) at postoperative 6-month follow-up.
Objective: To compare the surgical efficacy and safety of 120-degree, 240-degree, and 360-degree GT for patients with JOAG.
Patients and methods: This multicenter retrospective study included 102 eyes of 102 patients with JOAG, who underwent GT with a follow-up of at least 6 months. Patients were categorized into 3 groups: (1) 120-degree GT, (2) 240-degree GT, and (3) 360-degree GT. IOP, glaucoma medications, and complications were recorded at baseline and the final visit. Complete success and qualified success were defined as a postoperative IOP ≤21 mm Hg without and with medications, respectively.
Results: Mean age of the participants was 24.4 ± 7.9 years. After a mean follow-up of 8.1 ± 2.7 months, complete success rates were similar between the 240-degree GT (45.2%) and the 360-degree GT (63.2%; P = 0.135), and both were superior to 120-degree GT (18.2%; P < 0.05). Qualified success rates among patients in the 120-degree, 240-degree, and 360-degree GT groups were 93.9%, 96.8%, and 100%, respectively, and showed no statistically significant difference ( P = 0.292). 360-degree GT required fewer medications than 240-degree GT and 120-degree GT ( P < 0.05), with no significant difference in medications between 120-degree GT and 240-degree GT ( P > 0.05). Hyphema was the most common postoperative complication, with a significantly higher incidence in the 360-degree GT (68.4%) compared with the 240-degree GT (41.9%) and 120-degree GT (33.3%; P < 0.05).
Conclusions: 240-degree and 360-degree GT showed similar efficacy in IOP reduction and were superior to 120-degree GT. More extensive GT may provide better outcomes in JOAG.
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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