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Glaucoma Surgery Calculator: Limited Additive Effect of Phacoemulsification on Intraocular Pressure in Ab Interno Trabeculectomy

Neiweem, Ashley E ; Bussel, Igor I ; Schuman, Joel S ; Brown, Eric N ; Loewen, Nils A Gonzalez, Pedro

PloS one, 2016-04, Vol.11 (4), p.e0153585-e0153585 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Glaucoma Surgery Calculator: Limited Additive Effect of Phacoemulsification on Intraocular Pressure in Ab Interno Trabeculectomy
Autor: Neiweem, Ashley E ; Bussel, Igor I ; Schuman, Joel S ; Brown, Eric N ; Loewen, Nils A
Gonzalez, Pedro
Assuntos: Age ; Aged ; Aged, 80 and over ; Algorithms ; Analysis ; Biology and Life Sciences ; Care and treatment ; Cataracts ; Clinical decision making ; Cohort Studies ; Datasets ; Decision making ; Demographics ; Dosage and administration ; Eye surgery ; Female ; Gender ; Glaucoma ; Glaucoma - physiopathology ; Glaucoma - surgery ; Humans ; Intraocular Pressure ; Lens, Crystalline - physiopathology ; Lens, Crystalline - surgery ; Linear Models ; Male ; Matching ; Mathematical Concepts ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Missing data ; Multivariate Analysis ; Ophthalmic agents ; Ophthalmic drugs ; Ophthalmology ; Outcome Assessment (Health Care) - methods ; Patients ; Phacoemulsification - methods ; Physical Sciences ; Pressure ; Pseudophakia - physiopathology ; Pseudophakia - surgery ; Reduction ; Regression analysis ; Regression models ; Research and Analysis Methods ; Statistical analysis ; Surgery ; Trabecular Meshwork - physiopathology ; Trabecular Meshwork - surgery ; Trabeculectomy - methods ; Visual Field Tests
É parte de: PloS one, 2016-04, Vol.11 (4), p.e0153585-e0153585
Notas: ObjectType-Article-2
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Conceived and designed the experiments: NAL ENB IIB. Performed the experiments: AN ENB IIB. Analyzed the data: AN ENB IIB NAL. Contributed reagents/materials/analysis tools: JSS NAL. Wrote the paper: AN IIB JSS NAL.
Competing Interests: The authors have read the journal's policy and have the following competing interests: Nils Loewen has received honoraria for wet labs and lectures by Neomedix, Inc. The other authors have declared that no competing interests exist. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.
Descrição: To compare intraocular pressure (IOP) reduction and to develop a predictive surgery calculator based on the results between trabectome-mediated ab interno trabeculectomy in pseudophakic patients versus phacoemulsification combined with trabectome-mediated ab interno trabeculectomy in phakic patients. This observational surgical cohort study analyzed pseudophakic patients who received trabectome-mediated ab interno trabeculectomy (AIT) or phacoemulsification combined with AIT (phaco-AIT). Follow up for less than 12 months or neovascular glaucoma led to exclusion. Missing data was imputed by generating 5 similar but non-identical datasets. Groups were matched using Coarsened Exact Matching based on age, gender, type of glaucoma, race, preoperative number of glaucoma medications and baseline intraocular pressure (IOP). Linear regression was used to examine the outcome measures consisting of IOP and medications. Of 949 cases, 587 were included consisting of 235 AIT and 352 phaco-AIT. Baseline IOP between groups was statistically significant (p≤0.01) in linear regression models and was minimized after Coarsened Exact Matching. An increment of 1 mmHg in baseline IOP was associated with a 0.73±0.03 mmHg IOP reduction. Phaco-AIT had an IOP reduction that was only 0.73±0.32 mmHg greater than that of AIT. The resulting calculator to determine IOP reduction consisted of the formula -13.54+0.73 × (phacoemulsification yes:1, no:0) + 0.73 × (baseline IOP) + 0.59 × (secondary open angle glaucoma yes:1, no:0) + 0.03 × (age) + 0.09 × (medications). This predictive calculator for minimally invasive glaucoma surgery can assist clinical decision making. Only a small additional IOP reduction was observed when phacoemulsification was added to AIT. Patients with a higher baseline IOP had a greater IOP reduction.
Editor: United States: Public Library of Science
Idioma: Inglês

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Glaucoma Surgery Calculator: Limited Additive Effect of Phacoemulsification on Intraocular Pressure in Ab Interno Trabeculectomy

Neiweem, Ashley E ; Bussel, Igor I ; Schuman, Joel S ; Brown, Eric N ; Loewen, Nils A Gonzalez, Pedro

United States: Public Library of Science

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