Kontrola intraokularnog pritiska kod bolesnika sa primarnim glaukomom otvorenog ugla i pseudoeksfolijativnim glaukomom tokom perioda od 3 do 5 godina nakon trabekulektomije
Sažetak
Apstrakt
Uvod/Cilj. Trabekulektomija je sigurna procedura efikasnog snižavanja intraokularnog pritiska (IOP). IOP se uzima kao najčešće merilo uspeha nakon operacije glaukoma. Cilj rada je bio da se ispita dugoročan ishod nakon primarne trabekulektomije bez korišćenja antimetabolita uzimajući u obzir IOP kod bolesnika sa primarnim glaukomom otvorenog ugla i pseudoeksfolijativnim glaukomom u periodu od 3–5 godina nakon trabekulektomije. Metode. U studiji je retrospektivno praćeno 332 bolesnika (352 očiju), 174 bolesnika (188 očiju) sa primarnim glaukomom otvorenog ugla (prosečne starosti 64,0 ± 8,6 godina) i 158 bolesnika (164 očiju) sa pseudoeksfolijativnim glaukomom (prosečne starosti 70,7 ± 8,9 godina) kojima je izvršena trabekulektomija u periodu od januara 2007. do decembra 2009. godine na Odeljenju za glaukom Klinike za očne bolesti u Beogradu. Uspešna kontrola IOP je definisana postizanjem IOP manjim ili jednakim 21 mmHg, bez medikamentne antiglaukomne terapije (kompletan uspeh), ili sa jednom vrstom lokalne terapije (delimičan uspeh). Rezultati. Kod bolesnika sa primarnim glaukomom otvorenog ugla i sa pseudoeksfolijativnim glaukomom preoperativni IOP je bio 28,4 ± 6,3/30,4 ± 8,4 mmHg (p = 0,311), a postoperativni IOP 16,9 ± 5,2/18,7 ± 5,9 mmHg (p = 0,681). Na osnovu Kaplan-Meier-ove krive preživljavanja, kompletan uspeh kod bolesnika sa primarnim glaukomom otvorenog ugla nakon 1, 3 i 5 godina 85%, 75% i 58% s kod bolesnika sa pseudoeksfolijativnim glaukomom bio je 82%, 70% i 56%. Među posmatranim grupama nije bilo statistički značajne razlike. Zaključak. Primarni cilj operacije bio je postizanje dovoljno niskog intraokularnog pritiska bez dodatne terapije čime bi se sprečila progresija glaukomnog oštećenja. U našoj studiji kompletan uspeh u grupi bolesnika sa primarnim glaukomom otvorenog ugla postignut je u 75% i 58% bolesnika nakon 3, odnosno pet godina, dok je u grupi bolesnika sa pseudoeksfolijativnim glaukomom kompletan uspeh postignut u 70% i 56% bolesnika.
Reference
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