Modified CO2 Laser-assisted Sclerectomy Surgery in Chinese Patients With Primary Open-Angle Glaucoma and Pseudoexfoliative Glaucoma: A 2-Year Follow-up Study.
AI Summary
Modified CO2 laser-assisted sclerectomy (CLASS) effectively and safely lowered intraocular pressure long-term in Chinese glaucoma patients, reducing medication dependence and offering a viable surgical option.
Abstract
Precis: A modified CO2 laser-assisted sclerectomy surgery (CLASS) based on the characteristics of Chinese eyeball was carried out in Chinese patient and was confirmed to be effective and safe during long-term follow-up.
Purpose
The purpose of this study was to study the long-term efficacy and safety of modified CLASS in Chinese patients with primary open-angle and pseudoexfoliative glaucoma.
Methods
We enrolled 25 medically uncontrolled primary open-angle and pseudoexfoliative glaucoma patients in this prospective, interventional case series. A combination of modified CLASS and preoperative laser iris management was administered to 29 eyes. Visual acuity, intraocular pressure (IOP), slit-lamp examinations, visual field, and gonioscopy were carried out at baseline and until 24 months postoperatively. Ultrasound biomicroscopy examinations were repeated at 3, 12, and 24 months postsurgically.
Results
Mean patient age was 53.92±12.08 years. Mean preoperative IOP was 30.66±10.41 mm Hg; and mean postoperative IOP was 8.17±3.76, and 13.25±2.73, 13.76±2.50, and 13.76±2.50 mm Hg at 1 day, and 6, 12, and 24 months, respectively. Proportional changes in IOP from baseline at 6, 12, and 24 months was 58.33%, 56.25%, and 58.97% (P<0.001), respectively. Complete postoperative success rates at 12 and 24 months were 62.07% and 48.28%. Qualified success rates at 12 and 24 months postoperatively were both 89.66%. Number of medications administered per patient reduced from 3 at baseline to 0 at 12 and 24 months (P<0.0001). Two patients demonstrated severe peripheral anterior synechiae (6.90%). Ultrasound biomicroscopy examination revealed a severe scleral lake diminution in 1 patient (3.40%) at 12 months and 2 patients (6.90%) at 24 months.
Conclusion
Combination of modified CLASS and preventive laser iris management was effective and safe in the long-term treatment of primary open-angle glaucoma patients.
MeSH Terms
Shields Classification
Key Concepts5
Modified CO2 laser-assisted sclerectomy surgery (CLASS) combined with preoperative laser iris management resulted in a mean postoperative intraocular pressure (IOP) of 8.17±3.76 mm Hg at 1 day, 13.25±2.73 mm Hg at 6 months, 13.76±2.50 mm Hg at 12 months, and 13.76±2.50 mm Hg at 24 months in Chinese patients with primary open-angle glaucoma and pseudoexfoliative glaucoma.
The proportional changes in intraocular pressure (IOP) from baseline after modified CO2 laser-assisted sclerectomy surgery (CLASS) combined with preoperative laser iris management were 58.33% at 6 months, 56.25% at 12 months, and 58.97% at 24 months (P<0.001) in Chinese patients with primary open-angle glaucoma and pseudoexfoliative glaucoma.
Modified CO2 laser-assisted sclerectomy surgery (CLASS) combined with preoperative laser iris management achieved complete postoperative success rates of 62.07% at 12 months and 48.28% at 24 months, and qualified success rates of 89.66% at both 12 and 24 months postoperatively in Chinese patients with primary open-angle glaucoma and pseudoexfoliative glaucoma.
The number of glaucoma medications administered per patient reduced from 3 at baseline to 0 at 12 and 24 months (P<0.0001) following modified CO2 laser-assisted sclerectomy surgery (CLASS) combined with preoperative laser iris management in Chinese patients with primary open-angle glaucoma and pseudoexfoliative glaucoma.
Adverse events observed after modified CO2 laser-assisted sclerectomy surgery (CLASS) combined with preoperative laser iris management included severe peripheral anterior synechiae in 2 patients (6.90%) and severe scleral lake diminution in 1 patient (3.40%) at 12 months and 2 patients (6.90%) at 24 months in Chinese patients with primary open-angle glaucoma and pseudoexfoliative glaucoma.
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