Ferguson Tanner J, Berdahl John P, Schweitzer Justin A, Sudhagoni Ramu G
Sanford School of Medicine, University of South Dakota, Sanford School of Medicine, Sioux Falls, SD, USA.
Vance Thompson Vision, Sioux Falls, SD, USA.
Clin Ophthalmol. 2016 Sep 14;10:1767-1773. doi: 10.2147/OPTH.S114306. eCollection 2016.
To evaluate the safety and efficacy of the iStent trabecular microbypass stent in combination with cataract surgery in patients with open-angle glaucoma (OAG).
Retrospective, consecutive case series from October 2012 to December 2015 with no exclusion criteria. The series comprised of 350 eyes with OAG and cataract. Data were collected both preoperatively and postoperatively at day 1 week 1, months 1, 3, 6, 12, 18, and 24. Data included intraocular pressure (IOP), number of glaucoma medications, visual acuity, the incidence of postoperative IOP pressure spikes of greater than ≥15 mmHg at any time point, and need for additional surgery.
The mean preoperative IOP was 19.13±6.34 mmHg. At 2 years postoperation, mean IOP was 15.17±3.53 mmHg (<0.0001). The mean number of glaucoma medications was 1.19±1.00 preoperatively and 0.61±0.96 (<0.0001) at 2 years postoperation. At 1 day postoperatively, 31 eyes (12.4%) experienced an IOP increase of 15 mmHg above their baseline IOP that responded to topical therapy. Two patients required additional tube shunt surgery.
The insertion of the iStent trabecular microbypass stent in combination with cataract surgery effectively lowers IOP in OAG patients. The magnitude of IOP reduction was more significant in patients with higher preoperative pressure. Medication use was also significantly reduced postoperatively. The safety profile appears favorable with a low rate of IOP spikes and only two eyes (<1%) requiring additional surgery.
评估iStent小梁微旁路支架联合白内障手术治疗开角型青光眼（OAG）患者的安全性和有效性。
回顾性连续病例系列研究，时间跨度为2012年10月至2015年12月，无排除标准。该系列包括350只患有OAG和白内障的眼睛。在术前以及术后第1天、第1周、第1个月、第3个月、第6个月、第12个月、第18个月和第24个月收集数据。数据包括眼压（IOP）、青光眼药物使用数量、视力、术后任何时间点眼压升高≥15 mmHg的发生率以及是否需要额外手术。
术前平均眼压为19.13±6.34 mmHg。术后2年，平均眼压为15.17±3.53 mmHg（<0.0001）。术前青光眼药物平均使用数量为1.19±1.00，术后2年为0.61±0.96（<0.0001）。术后1天，31只眼睛（12.4%）眼压较基线眼压升高15 mmHg，经局部治疗后眼压下降。两名患者需要额外进行引流管分流手术。
iStent小梁微旁路支架联合白内障手术可有效降低OAG患者的眼压。术前眼压较高的患者眼压降低幅度更为显著。术后药物使用也显著减少。安全性良好，眼压峰值发生率低，仅两只眼睛（<1%）需要额外手术。
