Einfluss des Body-Mass-Index auf den Erfolg nach Trabektomoperation?

 

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Zusammenfassung

Einleitung: Ziel der Studie war es, einen möglichen Einfluss des Body-Mass-Index (BMI) auf das Ergebnis nach Trabektomoperation zu untersuchen.

Patienten und Methoden: 131 Augen mit primärem Offenwinkelglaukom (POWG), Myopieglaukom (MG) und Pseudoexfoliationsglaukom (PEXG), bei denen die Indikation zur Trabektomchirurgie gestellt wurde, wurden in diese retrospektive Studie eingeschlossen. Die Daten wurden der Freiburger Trabektomdatenbank von Juni 2009 bis April 2013 entnommen. Mittels eines Cox-Proportional-Hazards-Modells wurde der Einfluss des BMI auf das Operationsergebnis unter Berücksichtigung verschiedener Kovariaten (Alter, präoperative Tropftherapie) berechnet.

Ergebnis: Die Gruppe mit einem BMI > 25 kg/m² weist ein statistisch signifikant schlechteres Ergebnis bezogen auf den absoluten Erfolg (20 % Drucksenkung vom Ausgangsdruck ohne drucksenkende Medikation) nach Trabektomoperation auf (p = 0,047). Hinsichtlich des relativen Erfolgs sowie der Reoperationsrate waren keine statistisch signifikanten Unterschiede zu beobachten.

Schlussfolgerung: In unserer Patientenkohorte von 131 Augen war ein hoher BMI mit einer reduzierten Erfolgsaussicht assoziiert, solange ein absoluter Erfolg gefordert wird. Sind Medikamente akzeptabel (relativer Erfolg), ist kein Unterschied zu beobachten.

Abstract

Background: The aim of this study was to investigate a possible influence of body mass index (BMI) to the outcome of trabectome surgery.

Methods: 131 eyes with primary open angle glaucoma, myopia-associated glaucoma and pseudoexfoliation glaucoma were included into this retrospective study. The data were extracted from the Freiburg trabectome database from June 2009 to April 2013. We fitted a Cox proportional hazards model in order to assess the influence of the BMI on trabectome outcome.

Results: The absolute success after trabectome surgery (20 % pressure reduction without anti-glaucomatous medication) was statistically significantly better in the group with BMI > 25 kg/m² (p = 0.047). No statistically significant effect was observed for relative success or the rate of re-operation respectively.

Conclusion: In our patient cohort of 131 eyes, a high BMI was associated with a reduced success, as long as an absolute success is required. No difference is seen if additional anti-glaucomatous medication is acceptable (relative success).

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