Resultados a largo plazo de la trabeculectomía sola y de la combinada con facoemulsificación en pacientes con glaucoma primario de ángulo abierto. Instituto regional de Oftalmología 2015-2017
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Date
2002-12-05
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Universidad Nacional de Trujillo
Abstract
La cirugía de glaucoma es realizada con frecuencia en el Instituto Regional de Oftalmología, entre las técnicas más empleadas se encuentran la trabeculectomía sola y la trabeculectomía combinada con facoemulsificación cuyo objetivo principal es la reducción de la presión intraocular (PIO) para el control del glaucoma primario de ángulo abierto. ANTECEDENTES: Trabeculectomía sola es la técnica más usada, su tasa de éxito en manos expertas llega hasta el 90 % a los 2 años de seguimiento. La literatura define la tasa de éxito quirúrgico como incondicional, calificado o fracaso en base al control de la PIO y necesidad o no de medicamentos o realización de algún procedimiento adicional. Se ha estudiado también su realización asociada con facoemulsificación en pacientes portadores de catarata al momento de la intervención del glaucoma; así mismo la probabilidad de aparición o progresión de una catarata luego de la trabeculectomía, por lo que se piensa que una cirugía combinada de inicio puede ser beneficiosa al paciente. La literatura no es concluyente respecto a cuál de las 2 opciones quirúrgicas logran controlar más la presión intraocular en el tiempo en pacientes con glaucoma primario de ángulo abierto. OBJETIVO: Comparar el nivel de control de la PIO y la frecuencia de complicaciones posterior a trabeculectomía sola y a trabeculectomía asociada a facoemulsificación en pacientes con diagnóstico de glaucoma primario de ángulo abierto atendidos en el IRO JSU en el período 2015 a 2017. MÉTODOS : Estudio analítico, longitudinal, observacional, correlacional, retrospectivo de 2 cohortes, donde se incluirán todas las historias clínicas de pacientes con diagnóstico de glaucoma primario de ángulo abierto sometidos a trabeculectomía sola o combinada con facoemulsificación en el IRO JSU el período 2015 a 2017 y se analizara en base a datos como el porcentaje de éxito en relación al control de la presión intraocular (subdividiéndose en éxito incondicional, éxito calificado y fracaso) , frecuencia de complicaciones para cada procedimiento, edad, sexo y procedencia.
Glaucoma surgery is frequently performed at the Regional Institute of Ophthalmology, among the most used techniques are trabeculectomy alone and trabeculectomy combined with phacoemulsification whose main objective is the reduction of intraocular pressure (IOP) to control the Primary open angle glaucoma. BACKGROUND: Trabeculectomy alone is the most used technique, its success rate in expert hands reaches up to 90% after 2 years of follow-up. The literature defines the surgical success rate as unconditional, qualified, or failure based on IOP control and the need or lack of medication or performance of an additional procedure. Its use in association with phacoemulsification has also been studied in patients with cataract at the time of glaucoma surgery; Likewise, the probability of the appearance or progression of a cataract after trabeculectomy, so it is thought that a combined initial surgery may be beneficial to the patient. The literature is not conclusive regarding which of the 2 surgical options achieve greater control of intraocular pressure over time in patients with primary open-angle glaucoma. OBJECTIVE: Compare the level of IOP control and the frequency of complications after trabeculectomy alone and trabeculectomy associated with phacoemulsification in patients with a diagnosis of primary open-angle glaucoma treated at the IRO JSU in the period 2015 to 2017. METHODS: Analytical study , longitudinal, observational, correlational, retrospective of 2 cohorts, where all the clinical records of patients with a diagnosis of primary open-angle glaucoma undergoing trabeculectomy alone or combined with phacoemulsification at the IRO JSU in the period 2015 to 2017 will be included and will be analyzed in based on data such as the percentage of success in relation to the control of intraocular pressure (subdivided into unconditional success, qualified success and failure), frequency of complications for each procedure, age, sex and origin.
Glaucoma surgery is frequently performed at the Regional Institute of Ophthalmology, among the most used techniques are trabeculectomy alone and trabeculectomy combined with phacoemulsification whose main objective is the reduction of intraocular pressure (IOP) to control the Primary open angle glaucoma. BACKGROUND: Trabeculectomy alone is the most used technique, its success rate in expert hands reaches up to 90% after 2 years of follow-up. The literature defines the surgical success rate as unconditional, qualified, or failure based on IOP control and the need or lack of medication or performance of an additional procedure. Its use in association with phacoemulsification has also been studied in patients with cataract at the time of glaucoma surgery; Likewise, the probability of the appearance or progression of a cataract after trabeculectomy, so it is thought that a combined initial surgery may be beneficial to the patient. The literature is not conclusive regarding which of the 2 surgical options achieve greater control of intraocular pressure over time in patients with primary open-angle glaucoma. OBJECTIVE: Compare the level of IOP control and the frequency of complications after trabeculectomy alone and trabeculectomy associated with phacoemulsification in patients with a diagnosis of primary open-angle glaucoma treated at the IRO JSU in the period 2015 to 2017. METHODS: Analytical study , longitudinal, observational, correlational, retrospective of 2 cohorts, where all the clinical records of patients with a diagnosis of primary open-angle glaucoma undergoing trabeculectomy alone or combined with phacoemulsification at the IRO JSU in the period 2015 to 2017 will be included and will be analyzed in based on data such as the percentage of success in relation to the control of intraocular pressure (subdivided into unconditional success, qualified success and failure), frequency of complications for each procedure, age, sex and origin.
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Keywords
Trabeculectomía, Facoemulsificación, Glaucoma de Ángulo Abierto