TRABECULECTOMY COMBINED WITH BETA-IRRADIATION FOR CONGENITAL GLAUCOMA

被引:72
作者
MILLER, MH [1 ]
RICE, NSC [1 ]
机构
[1] MOORFIELDS EYE HOSP,CITY RD,LONDON EC1V 2PD,ENGLAND
基金
英国惠康基金;
关键词
D O I
10.1136/bjo.75.10.584
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Sixty-six eyes with congenital glaucoma were subjected to trabeculectomy between July 1975 and June 1989 are presented. Thirty-one were treated with beta-irradiation at the time of surgery with a strontium-90 applicator; 35 were not treated with beta-irradiation. The usual dose was 750 rad. Analysis was limited to three years because of the shorter follow-up of the irradiated eyes. Failure in the two groups was compared statistically. When failure was categorised as IOP > 21 mm Hg, beta-irradiation was found to be significantly protective with an adjusted risk ratio of 0.31 (95% confidence interval 0.11-0.90, p < 0.05). Failure categorised as the need for additional medical treatment or further surgery showed significant protection with an adjusted risk ratio of 0.33 (confidence interval 0.12-0.94, p < 0.05). Multiple regression models were used for the analysis of intraocular pressure; beta-irradiation was associated with a significantly lower IOP at six months, one year, and three years (p < 0.05). Other factors identified as being associated with a reduced failure rate or lower IOP were: no previous topical glaucoma medications: age over seven years; lack of previous surgery involving the conjunctiva. The results indicate that beta-irradiation may have a beneficial effect on the prognosis of trabeculectomy in children with congenital glaucoma. However, because of the retrospective and observational nature of the study, the results must be regarded as tentative.
引用
收藏
页码:584 / 590
页数:7
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