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Use of ultrasound biomicroscopy to predict the outcome of anterior segment reconstruction in congenital fibrovascular pupillary membrane with secondary glaucoma
British Journal of Ophthalmology ( IF 3.7 ) Pub Date : 2024-01-01 , DOI: 10.1136/bjo-2022-321762
Yingting Zhu 1 , Lei Fang 1 , Julius Oatts 2 , Ying Han 2 , Shufen Lin 1 , Liming Chen 1 , Xing Liu 3 , Yimin Zhong 3
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Aims To evaluate the efficacy and safety of anterior segment reconstruction (ASR) in congenital fibrovascular pupillary membrane-induced secondary glaucoma (CFPMSG) basing ultrasound biomicroscopy (UBM) classification. Methods This ambispective cohort study enrolled patients with CFPMSG who underwent ASR between January 2014 and September 2020. Comprehensive ophthalmic examinations and UBM were performed before surgery and postoperatively. The patients were classified into three types according to the UBM configurations. Anterior chamber recovery (ACR) was defined as deepening in anterior chamber (≥1.5 mm all through final follow-up (FFU), while success following ASR was defined as ACR and intraocular pressure (IOP)≤21 mm Hg. Results 25 eyes of 25 patients underwent ASR (average age at operation 5.8±5.0 months, 48% girls) with FFU 15.8±16.9 months. Enrolled subjects were classified into type Ⅰ (11 eyes), type Ⅱ (11 eyes) and type Ⅲ (3 eyes). After ASR, 23 eyes (92%) achieved ACR, and the mean ACD increased in all groups (p=0.006, <0.001 and 0.003, respectively). Eyes with types Ⅰ and Ⅱ demonstrated a reduction of IOP (p=0.009 and 0.002, respectively). ASR success rate was highest in type Ⅰ (72.9%) compared with types Ⅱ and Ⅲ (18.2% and 0%, respectively; p=0.011). ASR led to decreased number of antiglaucoma medications for type Ⅰ CFPMSG at FFU (p=0.016). No vision-threatening postoperative complications occurred. Conclusions ASR for CFPMSG results in increased ACD and improvement in IOP. Postoperative IOP control was best in type Ⅰ CFPMSG but not as effective in types Ⅱ and Ⅲ. UBM-based classification helps to predict the surgical outcome of ASR in CFPMSG. Data are available upon reasonable request.

中文翻译:


使用超声生物显微镜预测先天性纤维血管瞳孔膜继发性青光眼眼前节重建的结果



目的 根据超声生物显微镜 (UBM) 分类评估眼前节重建 (ASR) 在先天性纤维血管瞳孔膜诱发继发性青光眼 (CFPMSG) 中的有效性和安全性。方法 这项双向队列研究纳入了 2014 年 1 月至 2020 年 9 月期间接受 ASR 的 CFPMSG 患者。术前和术后均进行了全面的眼科检查和 UBM。根据UBM配置将患者分为三类。前房恢复(ACR)定义为前房深度加深(直至最终随访(FFU)≥1.5 mm,而 ASR 成功定义为 ACR 且眼压(IOP)≤21 mm Hg。结果 25 只眼25例患者接受ASR(平均手术年龄5.8±5.0个月,48%为女孩),FFU 15.8±16.9个月。纳入受试者分为Ⅰ型(11只眼)、Ⅱ型(11只眼)和Ⅲ型(3只眼)。 ASR 后,23 只眼睛 (92%) 达到 ACR,所有组的平均 ACD 均增加(分别为 Ⅰ 型和 Ⅱ 型眼睛,IOP 降低(p=0.009 和 0.003)。与 Ⅱ 型和 Ⅲ 型(分别为 18.2% 和 0%;p=0.011)相比,Ⅰ 型 ASR 成功率最高(72.9%)。 FFU (p=0.016)。结论 CFPMSG 的 ASR 导致 ACD 增加和术后 IOP 控制在 Ⅰ 型 CFPMSG 中效果最好,但在 Ⅱ 型和 Ⅲ 型中效果较差。基于 UBM 的分类有助于预测 CFPMSG 中 ASR 的手术结果。数据可根据合理要求提供。
更新日期:2023-12-18
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