Prediktori promene intraokularnog pritiska nakon operacije katarakte kod obolelih od pseudoeksfolijativnog glaukoma i kod bolesnika bez glaukoma
Sažetak
Uvod/Cilj. Operacija katarakte rezultira održivim sniže-njem intraokularnog pritiska (IOP) u očima sa ili bez glaukoma, ali je još uvek nejasno kod kojih će se bolesnika sa glaukomom postići klinički značajna redukcija IOP. Preoperativni IOP i neki okularni biometrijski parametri su se pokazali kao potencijalni prediktori postoperativnog sniže-nja IOP. Stoga je cilj naše prospektivne intervencijske studije bio da ispitamo taj odnos kod medikamentozno lečenih bolesnika sa pseudoeksfolijativnim glaukomom (PXG) i kod onih bez glaukoma. Metode. Ispitan je 31 bolesnik sa PXG (31 oko) i 31 bolesnik bez glaukoma (31 oko), svi sa klinički značajnom kataraktom. Preoperativni IOP, dubina prednje očne komore (ACD), aksijalna dužina (AL), debljina sočiva (LT), pozicija sočiva (LP) [LP = ACD + 0.5 LT], relativna pozicija sočiva (RLP) [RLP = LP/ AL] i indeks pritisak-dubina (PD indeks) [PD indeks = preoperativni IOP/preoperativni ACD] su ispitani kao potencijalni prediktori promene IOP u 6. postoperativnom mesecu. Rezultati. U 6. postoperativnom mesecu u grupi sa PXG, sniženje IOP je iznosilo -3.23 ± 3.41 mmHg (-17.67 ± 16.86%) u odnosu na preoperativnu vrednost IOP od 16.27 ± 3.08 mmHg, a u kontrolnoj grupi, sniženje je iznosilo
-2.26 ± 1.71 mmHg (-15.06 ± 10.93%) u odnosu na preoperativnu vrednost IOP od 14.53 ± 2.04 mmHg. U grupi sa PXG, značajni prediktori apsolutnog i relativnog sniženja IOP su bili preoperativne vrednosti IOP, AL i PD indeksa. U istoj grupi, RLP se pokazao kao značajan prediktor apsolutne promene IOP u multivarijantnoj analizi, a procentualne promene IOP i u univarijantnoj i multivarijantnoj analizi. U kontrolnoj grupi, preoperative vrednostii IOP i PD indeksa su bili jedini značajni parametri koji su mogli da ukažu na apsolutnu promenu IOP posle operacije katarakte. Zaključak. Operacija katarakte dovodi do sniženja IOP kod obolelih od PXG i kod bolesnika bez glaukoma. Prediktori ovog sniženja su široko dostupni parametri, jednostavni za izračunavanje i potencijalno se mogu koristiti u donošenju odluka o lečenju glaukoma.
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