Long-term Outcomes in Patients Undergoing Surgery for Primary Congenital Glaucoma between 1991 and 2000


Tags Glaucoma
Journal Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

Ophthalmology Volume 130, Number 11, November 2023


這篇文章討論了早產性青光眼 primary congenital glaucoma (PCG) 患者長期手術和視覺結果的估算。兩百二十個眼睛(一百二十一名患者)於1991年1月至2023年10月接受了原發性結膜穿刺腔輸入結膜混合手術 combined trabeculotomy-trabeculectomy (CTT)而無使用mitomycin C。Kaplan-Meier存活分析用於估算手術和功能成功的機率。在單變量分析中,任何額外的非青光眼眼內手術導致手術失敗風險較高。在多變量分析中,未發現任何臨床參數與失敗有顯著相關。在接受原發性CTT的眼睛中,28只(14.4%)需要第二次手術來控制眼壓。研究顯示CTT是一個有效的程序,對控制眼壓和中等視覺康復具有持久性效果,持續20年以上。

English Abstract

The purpose of the study was to evaluate the long-term surgical and visual outcomes in patients with primary congenital glaucoma (PCG) who underwent surgery, specifically the combined trabeculotomy-trabeculectomy (CTT) procedure. The study assessed the success rates and risk factors for surgical failure and poor visual outcomes. The researchers examined the records of 220 eyes of 121 patients who underwent surgery for PCG between January 1991 and 2011. Kaplane Meier survival analysisr evealed 1-year,10-year,and 20-year complete success rates of 90.7%,78.9%, and 44.5%, respectively. Overall,the proportion of eyes with good,fair, and poor visual outcomes was 33.2%, 16.4%, and 50.4%, respectively.The study found that CTT is a useful procedure for long-term intraocular pressure (IOP) control and moderate visual recovery in PCG patients over a 20-year follow-up period after surgery. The findings suggest that CTT without mitomycin C can be considered as the initial glaucoma procedure in children with PCG, as it can achieve good long-term surgical success and provide moderate visual outcomes. The study also highlighted the importance of long-term follow-up and the challenges of treating PCG, as patients often require multiple procedures for IOP control.