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iStent®小梁微旁路支架:最新进展

iStent® Trabecular Microbypass Stent: An Update.

作者信息

Resende Arthur Fernandes, Patel Neal Sanjay, Waisbourd Michael, Katz L Jay

机构信息

Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA 19107, USA.

出版信息

J Ophthalmol. 2016;2016:2731856. doi: 10.1155/2016/2731856. Epub 2016 Jun 20.

Abstract

Due to the high rates of complications and failure experienced with current glaucoma procedures, there is a continuous search for a safer and more effective glaucoma surgery. A new class of procedures termed minimally invasive glaucoma surgeries (MIGS) aim to fill this void by offering an alternative method of IOP reduction associated with markedly reduced complication rates and shorter recovery times. The iStent, a trabecular microbypass stent, is a MIGS device that has quickly gained popularity. The device allows aqueous humor to directly drain from the anterior chamber into Schlemm's canal by bypassing an obstructed trabecular meshwork. This review examines publications about the iStent, focusing on the device's efficacy, safety, and cost when a single iStent or multiple iStents are implanted in combination with cataract surgery or as a solo procedure. Current data suggest that the iStent is a safe and effective tool in the management of mild-to-moderate glaucoma, notable for its limited complications and absence of serious adverse events following implantation. As valuable experience is gained performing ab interno MIGS, increasing familiarity with angle anatomy and iStent placement, and as newer stent designs are developed, there is promise of continual improvement in the surgical management of glaucoma.

摘要

由于目前青光眼手术的并发症发生率和失败率较高,人们一直在不断寻求更安全、更有效的青光眼手术方法。一类名为微创青光眼手术(MIGS)的新型手术旨在通过提供一种降低眼压的替代方法来填补这一空白,这种方法具有显著降低的并发症发生率和更短的恢复时间。iStent是一种小梁微旁路支架,属于MIGS设备,已迅速受到欢迎。该设备可使房水绕过受阻的小梁网,直接从前房引流至施莱姆管。这篇综述研究了关于iStent的出版物,重点关注在与白内障手术联合植入单个iStent或多个iStent时,或作为单独手术时,该设备的疗效、安全性和成本。目前的数据表明,iStent是治疗轻至中度青光眼的一种安全有效的工具,其特点是并发症有限,植入后无严重不良事件。随着经内路MIGS手术经验的积累、对房角解剖结构和iStent放置的熟悉程度不断提高,以及新型支架设计的不断开发,青光眼手术管理有望持续改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ebf/4931099/a73fd3479fed/JOPH2016-2731856.001.jpg

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