유리체절제술을 시행 또는 예측되는 당뇨망막병증 환자에서 하비측 섬유주절제술의 결과 = The Outcome of Inferonasal Trabeculectomy in Diabetic Patients Who Expected or Had Vitrectomy

다국어 초록 (Multilingual Abstract)

Purposes: We evaluated the outcome of trabeculectomy using inferonasal bleb in diabetic retinopathy patients awaiting vitrectomy or on whom vitrectomy was performed. Methods: We retrospectively reviewed the medical records of patients who had undergone trabeculectomy with an inferonasal bleb from December 2002 to May 2005. Seven eyes had neovascular glaucoma secondary to the proliferative diabetic retinopathy, 6 eyes primary open angle glaucoma, and 4 eyes steroid induced glaucoma. We evaluated postoperative complication, intraocular pressure, the number of ocular hypotensive eye drops, and preoperative and postoperative best corrected visual acuity. Results: Mean follow-up period was 20.47±5.55 months. Most common complication was early ocular hypotony (4 eyes, 24%), but no blebitis and bleb associated endophthalmitis were observed. Mean intraocular pressure was reduced from 30.77±5.61 mm Hg preoperatively to 13.72±4.61 mm Hg at the most recent follow-up. The number of preoperative ocular hypotensive eye drops was 2.9±0.3 and that of postoperative eye dros was 1.4±1.0. The difference between these was statistically significant (p=0.000). Eleven eyes (61.11%) had a stable or improved visual acuity. Conclusions: Trabeculectomy using an inferonasal bleb appears to be a safe and effective surgical option that may be helpful in certain clinical situations, such as medically uncontrolled glaucomatous eyes with expected vitrectomy or vitrectomized eyes.

참고문헌 (Reference)

1 "Trabeculectomy:preliminary report of a new method" 66 : 673-9, 1968

2 "Trabeculectomy with mitomycin comparative study with fluorouracil" 109 : 1693-8, 1991

3 "Trabeculectomy at the inferior limbus" 114 : 387-391, 1996

4 "The initial fundus examination and severity of diabetic retinopathy at a primary eye clinic" 46 : 982-988, 2005

5 "The effect of intravitreal triamcinolone acetonide on intraocular pressure" 34 : 386-390, 2003

6 "Secondary chronic open-angle glaucoma after intravitreal triamcinolone acetonide" 121 : 729-730, 2003

7 "Outcome of functioning filtering blebs after pars plana vitrectomy" 27 : 367-373, 1996

8 "Outcome of eyes undergoing trabeculectomy after intravitreal injection of triamcinolone acetonide" 14 : 2005

9 "Neovascular glaucoma with diabetic retinopathy: Trabeculectomy and Nd:YAG cyclophoto- coagulation" 42 : 1581-1587, 2001

10 "Mid-term effects of trabeculectomy with mitomycin C in neovascular glaucoma patients" 15 : 98-106, 2001

11 "Late bleb-related endophthalmitis after trabeculectomy with adjunctive 5-fluorouracil" 98 : 1053-60, 1991

12 "Intraoperative mitomycin versus postoperative 5-fluorouracil in high-risk glaucoma filtering surgery" 99 : 438-44, 1992

13 "Intraocular pressure after intravitreal injection of triamcinolone acetonide" 87 : 24-27, 2003

14 "Filtering surgery in the treatment of neovascular glaucoma" 89 : 1181-7, 1982

15 "Endophthalmitis after filtering surgery with mitomycin" 114 : 943-949, 1996

16 "Cumulative incidence and risk factors of diabetic retinopathy" 36 : 1147-1154, 1995

17 "Comparison of mitomycin C trabeculectomy and Ahmed valve implant surgery for neovascular glaucoma" 42 : 1581-1587, 2001

18 "Bleb-related endophthalmitis after trabeculectomy with mitomycin C" 103 : 650-656, 1996

19 "A modified filtering operation for neovascular glaucoma" 97 : 2339-41, 1979

20 "A clinical analysis and referral rate on diabetic retinopathy in diabetic patients referred for eye examination at a tertiary hospital" 44 : 1093-1101, 2003

21 "5-fluorouracil filtering surgery and neovascular glaucoma. Long-term follow-up of the original pilot study." 102 : 887-893, 1995

22 "5-fluorouracil and glaucoma filtering surgery" 91 : 384-94, 1984