原发性开角型青光眼超声乳化术后眼内压的预测因素(美国眼科学会论文)。

Transactions of the American Ophthalmological Society Pub Date : 2017-10-23 eCollection Date: 2017-08-01
Shan C Lin, Marisse Masis, Travis C Porco, Louis R Pasquale
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引用次数: 0

摘要

目的:评价白内障手术后原发性开角型青光眼(POAG)患者的窄角状态和前段光学相干断层扫描(AS-OCT)参数是否能预测其眼压(IOP)下降。方法:采用标准化的术后管理方案,对无周围前粘连(PAS)的POAG患者进行连续白内障手术的前瞻性病例系列。术前行阴道镜和AS-OCT检查。1个月后恢复相同的青光眼药物治疗方案。潜在的IOP降低的预测因素包括角镜下的窄角状态和开角距离(AOD500)以及其他as - oct参数。混合效应回归调整了双眼和其他潜在混杂因素的使用。结果:纳入40例青光眼患者66只眼。1年后IOP降低4.2±3mmhg (26%, PPP=。027表示差异),通过阴道镜进行分类。AOD500分级:窄角组3.4±3 mm Hg (21%, PPP=。031表示差异)。当对整个队列进行评估时,虹膜厚度、虹膜面积和晶状体穹窿与1年后IOP降低的增加相关(p结论:在POAG眼中,白内障手术在窄角组的IOP降低程度大于广角组,虹膜厚度和面积以及晶状体穹窿相关参数与IOP降低相关。这些发现可以指导眼科医生选择白内障手术作为潜在的治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Predictors of Intraocular Pressure After Phacoemulsification in Primary Open-Angle Glaucoma Eyes with Wide Versus Narrower Angles (An American Ophthalmological Society Thesis).

Predictors of Intraocular Pressure After Phacoemulsification in Primary Open-Angle Glaucoma Eyes with Wide Versus Narrower Angles (An American Ophthalmological Society Thesis).

Predictors of Intraocular Pressure After Phacoemulsification in Primary Open-Angle Glaucoma Eyes with Wide Versus Narrower Angles (An American Ophthalmological Society Thesis).

Purpose: To assess if narrower-angle status and anterior segment optical coherence tomography (AS-OCT) parameters can predict intraocular pressure (IOP) drop in primary open-angle glaucoma (POAG) patients after cataract surgery.

Methods: This was a prospective case series of consecutive cataract surgery patients with POAG and no peripheral anterior synechiae (PAS) using a standardized postoperative management protocol. Preoperatively, patients underwent gonioscopy and AS-OCT. The same glaucoma medication regimen was resumed by 1 month. Potential predictors of IOP reduction included narrower-angle status by gonioscopy and angle-opening distance (AOD500) as well as other AS-OCT parameters. Mixed-effects regression adjusted for use of both eyes and other potential confounders.

Results: We enrolled 66 eyes of 40 glaucoma patients. The IOP reduction at 1 year was 4.2±3 mm Hg (26%, P<.001) in the narrower-angle group vs 2.2±3 mm Hg (14%, P<.001) in the wide-angle group (P=.027 for difference), as classified by gonioscopy. By AOD500 classification, the narrower-angle group had 3.4±3 mm Hg (21%, P<.001) reduction vs 2.5±3 mm Hg (16%, P<.001) in the wide-angle group (P=.031 for difference). When the entire cohort was assessed, iris thickness, iris area, and lens vault were correlated with increasing IOP reduction at 1 year (P<.05 for all).

Conclusions: In POAG eyes, cataract surgery lowered IOP to a greater degree in the narrower-angle group than in the wide-angle group, and parameters relating to iris thickness and area, as well as lens vault, were correlated with IOP reduction. These findings can guide ophthalmologists in their selection of cataract surgery as a potential management option.

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