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Stratification of phaco-trabectome surgery results using a glaucoma severity index in a retrospective analysis

BACKGROUND: To stratify the outcomes of phacoemulsification combined with trabectome surgery using a new glaucoma severity index. METHODS: This is a retrospective, observational cohort study that included open angle glaucoma patients with visually significant cataract that had phacoemulsification co...

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Autores principales: Roy, Pritha, Loewen, Ralitsa T., Dang, Yalong, Parikh, Hardik A., Bussel, Igor I., Loewen, Nils A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360039/
https://www.ncbi.nlm.nih.gov/pubmed/28327135
http://dx.doi.org/10.1186/s12886-017-0421-7
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author Roy, Pritha
Loewen, Ralitsa T.
Dang, Yalong
Parikh, Hardik A.
Bussel, Igor I.
Loewen, Nils A.
author_facet Roy, Pritha
Loewen, Ralitsa T.
Dang, Yalong
Parikh, Hardik A.
Bussel, Igor I.
Loewen, Nils A.
author_sort Roy, Pritha
collection PubMed
description BACKGROUND: To stratify the outcomes of phacoemulsification combined with trabectome surgery using a new glaucoma severity index. METHODS: This is a retrospective, observational cohort study that included open angle glaucoma patients with visually significant cataract that had phacoemulsification combined with trabectome surgery. Exclusion criteria were follow-up less than 12 months, any other surgeries or diagnosis of neovascular or active uveitic glaucoma. Patients were stratified into four groups according to the Glaucoma Index (GI) that incorporated preoperative intraocular pressure (IOP), number of medications and visual field status. The primary outcome measures were IOP reduction and the success rate at 12 months. We examined the relationship between GI group and IOP and medications at one year with a linear regression analysis and survival with log-rank testing. RESULTS: Of 1374 patients, a total of 498 cases with 12 month follow-up were included in the study after applying the exclusion criteria. At one year, IOP of GI groups 1 through 4 was reduced by 2.9 ± 4.4, 3.6 ± 5.0, 3.9 ± 5.3, and 9.2 ± 7.6 mmHg for. Individuals in the next higher GI group had a 1.69 ± 0.2 mmHg larger IOP decrease. The success rate was 98%, 93%, 96% and 88% at one year for GI groups 1 to 4 (p < 0.05). CONCLUSIONS: A substantial IOP reduction was seen in subjects with more advanced glaucoma suggesting that the trabecular meshwork is the primary impediment to outflow and its ablation benefits those eyes relatively more than in mild glaucoma. A larger IOP reduction can be expected in individuals with a higher GI group that indicates a clinically more challenging glaucoma.
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spelling pubmed-53600392017-03-24 Stratification of phaco-trabectome surgery results using a glaucoma severity index in a retrospective analysis Roy, Pritha Loewen, Ralitsa T. Dang, Yalong Parikh, Hardik A. Bussel, Igor I. Loewen, Nils A. BMC Ophthalmol Research Article BACKGROUND: To stratify the outcomes of phacoemulsification combined with trabectome surgery using a new glaucoma severity index. METHODS: This is a retrospective, observational cohort study that included open angle glaucoma patients with visually significant cataract that had phacoemulsification combined with trabectome surgery. Exclusion criteria were follow-up less than 12 months, any other surgeries or diagnosis of neovascular or active uveitic glaucoma. Patients were stratified into four groups according to the Glaucoma Index (GI) that incorporated preoperative intraocular pressure (IOP), number of medications and visual field status. The primary outcome measures were IOP reduction and the success rate at 12 months. We examined the relationship between GI group and IOP and medications at one year with a linear regression analysis and survival with log-rank testing. RESULTS: Of 1374 patients, a total of 498 cases with 12 month follow-up were included in the study after applying the exclusion criteria. At one year, IOP of GI groups 1 through 4 was reduced by 2.9 ± 4.4, 3.6 ± 5.0, 3.9 ± 5.3, and 9.2 ± 7.6 mmHg for. Individuals in the next higher GI group had a 1.69 ± 0.2 mmHg larger IOP decrease. The success rate was 98%, 93%, 96% and 88% at one year for GI groups 1 to 4 (p < 0.05). CONCLUSIONS: A substantial IOP reduction was seen in subjects with more advanced glaucoma suggesting that the trabecular meshwork is the primary impediment to outflow and its ablation benefits those eyes relatively more than in mild glaucoma. A larger IOP reduction can be expected in individuals with a higher GI group that indicates a clinically more challenging glaucoma. BioMed Central 2017-03-21 /pmc/articles/PMC5360039/ /pubmed/28327135 http://dx.doi.org/10.1186/s12886-017-0421-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Roy, Pritha
Loewen, Ralitsa T.
Dang, Yalong
Parikh, Hardik A.
Bussel, Igor I.
Loewen, Nils A.
Stratification of phaco-trabectome surgery results using a glaucoma severity index in a retrospective analysis
title Stratification of phaco-trabectome surgery results using a glaucoma severity index in a retrospective analysis
title_full Stratification of phaco-trabectome surgery results using a glaucoma severity index in a retrospective analysis
title_fullStr Stratification of phaco-trabectome surgery results using a glaucoma severity index in a retrospective analysis
title_full_unstemmed Stratification of phaco-trabectome surgery results using a glaucoma severity index in a retrospective analysis
title_short Stratification of phaco-trabectome surgery results using a glaucoma severity index in a retrospective analysis
title_sort stratification of phaco-trabectome surgery results using a glaucoma severity index in a retrospective analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360039/
https://www.ncbi.nlm.nih.gov/pubmed/28327135
http://dx.doi.org/10.1186/s12886-017-0421-7
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