在儿童中接受结扣和青光眼排水装置的风险因素
Mariana Abi Karam1, Arjun Sharma1, Ashley Lopez-Canizares1
1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street .450N, Miami, FL, 33136, USA.
Scientific reports
|October 25, 2024
概括
儿科患者需要既需要眼排水装置 (GDD),又需要眼扣 (SB) 手术,如果他们有创伤史或使用多重眼药物,则面临更高的风险. 创伤显著增加了需要这两种手术的可能性.
科学领域:
- 眼科医生 眼科 眼科
- 儿科手术 儿科手术
- 视光眼管理 视光眼管理
背景情况:
- 青光眼排水装置 (GDD) 和结膜扣 (SB) 分别是针对儿科青光眼和视网膜脱落的手术干预.
- 了解儿童患者需要GDD和SB的风险因素对于手术规划和患者咨询至关重要.
- 以前的研究还没有全面评估儿童群体对GDD和SB的顺序需求.
研究的目的:
- 为了确定与儿童患者相关的风险因素,需要在初始结扣 (SB) 手术后使用青光眼排水装置 (GDD).
- 为了确定与儿童患者相关的风险因素,需要在初始绿内障排水装置 (GDD) 植入后进行膜扣 (SB).
- 分析GDD或SB手术的儿科眼睛中二次手术的指示和时间.
主要方法:
- 在2013年至2021年期间接受SB或GDD手术的儿科患者 (<18岁) 的回顾性评估.
- 分析了两个组:"SB-first" (没有先前GDD的SB安置) 和"GDD-first" (没有先前SB的GDD植入).
- 统计分析,包括危险比率 (HR),用于确定需要替代设备的风险因素.
主要成果:
- 在SB第一组 (133只眼睛) 中,9%需要随后的GDD植入. 创伤 (HR 4.81) 和每一个额外的玻璃眼药物在SB前 (增加1.81的风险) 都是显著的风险因素.
- 对于SB-first手术的常见症状包括视网膜脱落 (41.2%),重创伤 (21%) 和病理近视 (11%).
- 在GDD第一组 (135只眼睛) 中,3%需要随后的SB植入. 创伤是统计学上唯一显著的风险因素 (HR 12.3).
结论:
- 儿童眼睛有创伤史或多种先前存在的玻璃眼药物具有显著更高的风险需要SB和GDD.
- 眼科医生应该在规划儿科玻璃眼和视网膜疾病的初始手术干预时仔细考虑这些风险因素.
- 进一步的研究可能会探索对被确定为高风险患者的预防策略.
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