Comparison of Medical and Surgical Treatment in Advanced Glaucoma

藥物及手術治療在末期青光眼的預後

吳敏慧(Min-Hui Wu) ； 李世煌(Shami Shi-Huang Lee)

《中華民國眼科醫學會雜誌》 41卷1期 (2002/03) Pp. 25-29

https://doi.org/10.30048/ACTASOS.200203.0007

摘要

目的：比較末期青光眼患者在診斷之初，分別施以小樑切除術，或僅以藥物控制之視力預後。
方法：本篇收集1987至1997年10年之間，在台中榮總初始診斷為末期青光眼的病人，從病例中收集病人的眼壓、視力及視野變化之資料共59位，依照手術組及藥物治療組兩組加以分析。
結果：小樑切除術可以將眼壓控制在15mmHg以下，視野退化的比例在小樑切除術組為13.3%，以每年3.5%的比例退化。而在藥物控制組中，視野退化比例為48.3%，以每年16.8%的比例退化；視力下降2行以上之患者在小樑切除術組中為26.7%，而在藥物控制組中為51.7%。
結論：比較眼壓的控制、視力及視野的預後，小樑切除術應為末期青光眼患者初始治療的最佳方法。

並列摘要

Purpose: This study was aimed to compare the long-term prognosis in advanced glaucoma between medical treated group and surgical treated group.
Methods: Fifty-nine eyes of 59 patients presented as advanced glaucoma with a minimum follow-up of 10 years were enrolled into the retrospective study. Some of the patients received medical control only, and the others received trabeculectomy soon after presentation. A paired Students' T test was used to assess the serial automated perimetry, intraocular pressures and change of visual acuity.
Results: Trabeculectomy attained target pressure below 15mmHg. Deterioration of visual field was 13.3% in trabeculectomy group and 48.3% in medical treated group. Visual field progression per year was 3.5% in surgical group and 16.8% in medical group. Visual acuity loss was 26.7% in trabeculectomy group and 51.7% in medical group.
Conclusion: As long-term prognosis is considered, trabeculectomy may be the best choice as initial treatment for advanced glaucoma.

並列關鍵字

glaucoma ； visual field ； visual acuity