Japanese journal of ophthalmology · 2016
Influence of high myopia on outcomes of trabeculectomy with mitomycin C in patients with primary open-angle glaucoma.
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Tanaka Daisuke, Nakanishi Hideo, Hangai Masanori, Akagi Tadamichi, Morooka Satoshi, Ikeda Hanako Ohashi, Yoshimura Nagahisa
Аннотация
PURPOSE: To determine the clinical characteristics and surgical outcomes of highly myopic (HM) eyes with an axial length (AL) of ≥26.0 mm that underwent trabeculectomy with mitomycin C (MMC).
METHODS: This was a retrospective study of 63 eyes of 54 patients with primary open-angle glaucoma that underwent trabeculectomy with MMC. The characteristics and surgical outcomes of 19 HM eyes were compared with those of 44 non-HM eyes. Surgical success was defined as an high intraocular pressure (IOP) of ≤21 mmHg (criterion A), ≤18 mmHg (criterion B), or ≤15 mmHg (criterion C), with a lower IOP cutoff of 6 mmHg and a >20 % reduction regardless of the use of antiglaucoma medication. Cox regression analyses were performed to evaluate the effect of each pretreatment and surgical factor on the success rate.
RESULTS: Patients with HM eyes were significantly younger than those with non-HM eyes (mean age 64.1 ± 9.9 vs. 69.1 ± 9.5 years; P < 0.05). The 3-year qualified success rates for HM eyes and non-HM eyes did not differ significantly for the three criteria. Younger age [hazard ratio (HR) for a 1-year increase 0.93, P < 0.005], preoperative pseudophakia (HR 3.88, P < 0.005), and shorter AL (HR for a 1-mm increase 0.72, P < 0.05) were found to be significant risk factors for trabeculectomy failure based on an IOP of ≤15 mmHg (criterion C). Age and pseudophakia also had significant effects on trabeculectomy failure based on criteria A and B, and the AL had a significant influence based on criterion A.
CONCLUSIONS: In our patient cohort a longer AL was not a risk factor for trabeculectomy failure, but it may be a success factor for trabeculectomy with MMC.
METHODS: This was a retrospective study of 63 eyes of 54 patients with primary open-angle glaucoma that underwent trabeculectomy with MMC. The characteristics and surgical outcomes of 19 HM eyes were compared with those of 44 non-HM eyes. Surgical success was defined as an high intraocular pressure (IOP) of ≤21 mmHg (criterion A), ≤18 mmHg (criterion B), or ≤15 mmHg (criterion C), with a lower IOP cutoff of 6 mmHg and a >20 % reduction regardless of the use of antiglaucoma medication. Cox regression analyses were performed to evaluate the effect of each pretreatment and surgical factor on the success rate.
RESULTS: Patients with HM eyes were significantly younger than those with non-HM eyes (mean age 64.1 ± 9.9 vs. 69.1 ± 9.5 years; P < 0.05). The 3-year qualified success rates for HM eyes and non-HM eyes did not differ significantly for the three criteria. Younger age [hazard ratio (HR) for a 1-year increase 0.93, P < 0.005], preoperative pseudophakia (HR 3.88, P < 0.005), and shorter AL (HR for a 1-mm increase 0.72, P < 0.05) were found to be significant risk factors for trabeculectomy failure based on an IOP of ≤15 mmHg (criterion C). Age and pseudophakia also had significant effects on trabeculectomy failure based on criteria A and B, and the AL had a significant influence based on criterion A.
CONCLUSIONS: In our patient cohort a longer AL was not a risk factor for trabeculectomy failure, but it may be a success factor for trabeculectomy with MMC.