Intraocular Pressure and Medication Burden With Cataract Surgery Alone, or Cataract Surgery Combined With Trabecular Bypass or Goniotomy

被引：3

作者：

McNiel, Christopher L. ^{[1
,2
,3
]}

Sanchez, Facundo G. ^{[1
,2
]}

Rees, Jack P. ^{[1
,2
]}

Gardiner, Stuart K. ^{[1
,2
]}

Young, Jonathan W. ^{[1
,2
]}

Kinast, Robert M. ^{[1
,2
]}

Young, Amber ^{[1
,2
]}

Jones, Emily P. ^{[1
,2
]}

Mansberger, Steven L. ^{[1
,2
]}

机构：

[1] Legacy Devers Eye Inst, 1040 NW 22nd Ave,Suite 200, Portland, OR 97210 USA

[2] Legacy Hlth, Discoveries In Sight Res Labs, Portland, OR USA

[3] Western Univ Hlth Sci, Dept Osteopath Med, Lebanon, OR USA

来源：

JOURNAL OF GLAUCOMA | 2022年 / 31卷 / 06期

关键词：

trabecular bypass; goniotomy; cataract surgery; glaucoma; intraocular pressure; ocular hypotensive medications; OPEN-ANGLE GLAUCOMA; CLEAR CORNEAL PHACOEMULSIFICATION; OPTIC-NERVE HEAD; LENS IMPLANTATION; RISK-FACTORS; FOLLOW-UP; REDUCTION; ELEVATION; EXTRACTION; STENT;

D O I：

10.1097/IJG.0000000000002028

中图分类号：

R77 [眼科学];

学科分类号：

100212 ;

摘要：

Precis: When compared with cataract surgery in glaucoma patients, trabecular micro-bypass and goniotomy resulted in a large decrease in the incidence of intraocular pressure (IOP) spikes, a modest effect on IOP, and a minimal effect on medication burden. Purpose: To compare changes in IOP and ocular hypotensive medications in 3 surgical cohorts: cataract surgery, cataract surgery with trabecular micro-bypass (cataract/trabecular), and cataract surgery with goniotomy (cataract/goniotomy). Materials and Methods: We included 138 eyes diagnosed with open-angle glaucoma: (1) 84 eyes with cataract surgery alone, (2) 25 eyes with cataract/trabecular surgery, and (3) 29 eyes with cataract/goniotomy surgery. We compared the groups for postoperative IOP and the number of ocular hypotensive medications. We adjusted for preoperative IOP, and preoperative and postoperative number of ocular hypotensive medications. We defined an IOP spike as IOP >= 21 mm Hg and 10 mm Hg higher than preoperative on postoperative day 1. Results: All 3 surgeries showed a decrease in IOP (P <= 0.004) and medication burden (P <= 0.001) at 3 and 6 months postoperatively when compared with their own preoperative baselines. When compared with cataract surgery alone, cataract/trabecular and cataract/goniotomy had similar IOP lowering at 1 month postoperatively, and variable results at 3 and 6 months. The change in ocular hypotensive medications was not statistically different between the surgical groups at any postoperative visit. Cataract/trabecular and cataract/goniotomy decreased IOP on postoperative day 1, and had relative risk reduction of similar to 70% for IOP spikes (P <= 0.001 for both). Conclusion: Trabecular micro-bypass and goniotomy when added to cataract surgery resulted in a large decrease in IOP spikes, a modest effect on IOP, and a minimal effect on medication burden when compared with cataract surgery alone in glaucoma patients.

引用

页码：423 / 429

页数：7

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