Avtor/Urednik		Hudovernik, Mojca; Pahor, Dušica
Naslov		Štiriletno spremljanje bolnikov po goniotrepanaciji
Prevedeni naslov		4-years follow up of patients after goniotrepanation
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 71, št. Suppl 2
Leto izdaje		2002
Obseg		str. II-55-7
Jezik		slo
Abstrakt		Background. To present the success of goniotrepanation in patients with glaucoma 4 years after surgery. Methods. We performed follow-up of 32 patients (50 eyes), who had undergone Fronimopoulus goniotrepanation without use of antimetabolites in our department because of poorly controlled primary open-angle or angle-closure glaucoma and pseudoexfoliative glaucoma between January 1995 and May 1996. The success of operation was assessed 4 years after operation by evaluating the stability of the visual field, stability of the optic nerve head changes and values of the intraocular pressure (IOP) lower than 21 Hg. Results. Mean preoperative IOP was 27 mm Hg, one year postoperatively IS mm Hg and 4 years after the surgery 14 mm Hg (mean drop of IOP was 48%). 1 year after surgery IOP was lower than 21 mm Hg without treatment in 37 eyes (74%) and with additional topical treatment in 12 eyes (24%). After 4 years additional topical treatment was necessary in 54% eyes. Only in 2 patients (4%) revision soon aftersurgery was performed (because of Tenon's cyst in one case and hypotony in the other). In 1 eye (2%) intraoperative subchoroidal expulsive hemorrhage occurred. In 19 eyes (39%) cataract developed 4 years after surgery. The success of surgery after 4 years was 94%; in 22 eyes(44%) without treatment, in 25 eyes (50%) with additional topical treatment and in 2 eyes (4%) additional surgery was needed.Conclusions. Goniotrepanation without use of antimetabolites can be effective treatment for patients with pseudoexfoliative glaucoma and open-angle glaucoma.
Izvleček		Izhodišča. Namen prispevka je prikazati urejenost glavkomske bolezni 4 leta po goniotrepanaciji. Metode. V retrospektivno študijo smo vključili vseh 32 bolnikov (50 oči), pri katerih je bila na našem oddelku narejena goniotrepanacija po Fronimopoulosu brez uporabe antimetabolitov zaradi dekompenziranega primarnega glavkoma odprtega ali zaprtega zakotja ter psevdoeksfoliativnega glavkoma med januarjem 1995 in majem 1996. Uspešnost operacije smo ocenjevali s stabilnim vidnim poljem in izgledom papile očesnega živca ter očesnim tlakom (IOP) pod 21 mm Hg 4 leta po opravljeni operaciji. Rezultati. IOP je pred operacijo v povprečju znašal 27 mm Hg, 1 leto po operaciji 15 mm Hg in po 4 letih 14 mm Hg (povprečno znižanje IOP je torej 48%). 1 leto po operaciji je bil IOP pri 37 očeh (74%) pod 21 mm Hg brez, pri 12 (24%) pa ob dodatnem lokalnem medikamentnem zdravljenju. Čez 4 leta je bilo potrebno dodatno lokalno zdravljenje pri 54% oči. Le pri 2 bolnikih (4%) je bila kmalu po operaciji narejena revizija (pri enem zaradi Tenonove ciste, pri drugem pa zaradi hipotonije). Pri 1 očesu (2%) pa je prišlo do medoperativne subhoroidalne ekspulzivne krvavitve in nato posledične atrofije očesa. Pri 19 očeh (39%) je v 4 letih po operaciji katarakta napredovala. Uspešnost operacije po 4 letih je bila torej 94%; pri 22 očeh (44%) brez dodatnega zdravljenja, pri 25 očeh (50%) je bilo potrebno dodatno lokalno medikamentno zdravljenje, pri 2 očeh (4%) pa je bil potreben ponovni poseg. Zaključki. Menimo, da je geniotrepanacija ustrezna operativna metoda pri primarnih glavkomih in psevdoeksfoliativnem glavkomu tudi brez uporabe antimetabolitov.
Deskriptorji		GLAUCOMA TRABECULECTOMY TREATMENT OUTCOME