Extended pharmacological miosis is superfluous after glaucoma angle surgery: A retrospective study
Autor: | Hamed Esfandiari, Nils A. Loewen, Mehdi Yaseri, Kiana Hassanpour |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Miosis
Intraocular pressure medicine.medical_specialty genetic structures medicine.medical_treatment Trabectome surgery Glaucoma General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine peripheral anterior synechiae medicine miotics Trabeculectomy Trabectome General Pharmacology Toxicology and Pharmaceutics 10. No inequality pilocarpine eye drop General Immunology and Microbiology Proportional hazards model business.industry Retrospective cohort study General Medicine Articles medicine.disease eye diseases 3. Good health Surgery Pilocarpine 030221 ophthalmology & optometry medicine.symptom business ab interno trabeculectomy 030217 neurology & neurosurgery medicine.drug Research Article |
Zdroj: | F1000Research |
ISSN: | 2046-1402 |
Popis: | Background: Pilocarpine is commonly used after angle surgery for glaucoma despite a host of side effects and risks. We hypothesized that a pharmacological miosis during the first two months does not improve short- and long-term results of trabectome-mediated ab interno trabeculectomy. Methods: In this retrospective comparative 1-year case series, we compared 187 trabectome surgery eyes with (P+) or without (P-) 1% pilocarpine for two months. Primary outcome measures were the surgical success defined as intraocular pressure (IOP) ≤ 21 mmHg and decreased ≥ 20%, and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, and IOP. Results: We categorized 86 (46%) eyes as P- and 101 (54%) eyes as P+. The mean age was 69.8±10.1 in P- and 70.5±9.4 in P+ (P=0.617) with equal gender distribution (P=0.38). The cumulative probability of qualified success at 12 months was 78.1% in the P- and 81% in the P+ (P=0.35). The IOP was decreased significantly from 20.2±6.8 mmHg at baseline to 15.0±4.8 mmHg at 12 months follow-up in P- (P=0.001) and 18.8±5.3 and 14.7±4.0, respectively (P=0.001). The medications decreased significantly from 1.4±1.2 in P- and 1.4±1.2 in P+ at baseline to 1.0±1.2 and 0.7±1.0, respectively (P=0.183). P- and P+ did not differ in IOP or medications (all P>0.05). In Multivariate Cox Regression models, the baseline IOP and central corneal thickness were associated with failure. Conclusions: Use of postoperative pilocarpine does not improve the efficacy of trabectome surgery. |
Databáze: | OpenAIRE |
Externí odkaz: |