دورية أكاديمية
أعرض في EDS

A Retrospective Comparison of Phaco-tube vs. Phaco-trabeculectomy in Glaucoma Patients.

التفاصيل البيبلوغرافية
العنوان: A Retrospective Comparison of Phaco-tube vs. Phaco-trabeculectomy in Glaucoma Patients.
المؤلفون: Llaneras CN; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida., Quan A; Division of Ophthalmology, Scripps Clinic, La Jolla, California., Lieux C; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida., Rivera-Grana E; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida., Gajardo C; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida., Duerr E; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida., O'Brien RC; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida., Gedde SJ; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida., Vazquez LE; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: LVazquez@med.miami.edu.
المصدر: Ophthalmology. Glaucoma [Ophthalmol Glaucoma] 2024 Sep-Oct; Vol. 7 (5), pp. 466-475. Date of Electronic Publication: 2024 Apr 30.
نوع المنشور: Journal Article; Comparative Study
اللغة: English
بيانات الدورية: Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101730510 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2589-4196 (Electronic) Linking ISSN: 25894196 NLM ISO Abbreviation: Ophthalmol Glaucoma Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York : Elsevier Inc., [2018]-
مواضيع طبية MeSH: Trabeculectomy*/methods , Phacoemulsification*/methods , Intraocular Pressure*/physiology , Visual Acuity* , Glaucoma*/surgery , Glaucoma*/physiopathology , Glaucoma*/complications , Glaucoma Drainage Implants*, Humans ; Retrospective Studies ; Male ; Female ; Aged ; Middle Aged ; Treatment Outcome ; Follow-Up Studies ; Mitomycin/administration & dosage ; Aged, 80 and over
مستخلص: Purpose: To compare surgical outcomes of phacoemulsification combined with Baerveldt implantation (phaco-tube) or trabeculectomy with mitomycin-C (MMC) (phaco-trab) in patients without prior incisional ocular surgery.
Design: Single-center, retrospective, comparative case series.
Participants: A total of 90 patients underwent surgical treatment, including 45 patients in the phaco-tube group and 45 patients in the phaco-trab group.
Methods: Eligible patients were identified using current procedural terminology (CPT) codes, and their medical records were retrospectively reviewed.
Main Outcome Measures: The primary outcome measure was the rate of surgical failure (IOP ≤5 mmHg or >21 mmHg or reduced <20% from baseline on 2 consecutive study visits after 3 months, reoperations for glaucoma, or experienced loss of light perception vision). Patients who had successful surgical outcomes without use of glaucoma medications were classified as complete successes, while those who used glaucoma medications were classified as qualified successes. Secondary outcome measures were visual acuity (VA), visual field mean deviation (VFMD), intraocular pressure (IOP), glaucoma medication use, and complications.
Results: The cumulative probability of failure was 6.7% in the phaco-tube group and 32.8% in the phaco-trab group after 3 years (P = 0.005; Restricted Mean Survival Time = 5.9 months, 95% CI = 1.4-10.4 months). The IOP was 13.1 ± 3.4 mmHg in the phaco-tube group and 13.3 ± 6.2 mmHg in the phaco-trab group at 3 years (P = 0.90), and the number of glaucoma medications was 2.6 ± 1.5 in the phaco-tube group and 1.7 ± 1.3 in the phaco-trab group (P = 0.015). The logarithm of the minimum angle of resolution VA was 0.39 ± 0.58 in the phaco-tube group and 0.43 ± 0.73 in the phaco-trab group at 3 years (P = 0.82), and VFMD was -18.3 ± 9.0 dB in the phaco-tube group and -14.1 ± 7.0 dB in the phaco-trab group (P = 0.16). Postoperative complications developed in 21 patients (47%) in the phaco-tube group and 15 patients (33%) in the phaco-trab group (P = 0.28).
Conclusions: Phaco-tubes had a significantly lower rate of surgical failure compared to phaco-trabs after 3 years of follow-up. However, phaco-trabs used significantly fewer glaucoma medications at multiple postoperative timepoints and had a higher proportion of complete success.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
(Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
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معلومات مُعتمدة: P30 EY014801 United States EY NEI NIH HHS
فهرسة مساهمة: Keywords: Glaucoma surgery; Phacoemulsification; Trabeculectomy; Tube shunt
المشرفين على المادة: 50SG953SK6 (Mitomycin)
تواريخ الأحداث: Date Created: 20240502 Date Completed: 20240921 Latest Revision: 20240923
رمز التحديث: 20240923
مُعرف محوري في PubMed: PMC11416338
DOI: 10.1016/j.ogla.2024.04.008
PMID: 38697359
قاعدة البيانات: MEDLINE
الوصف
تدمد:2589-4196
DOI:10.1016/j.ogla.2024.04.008