开角型青光眼患者中行超声乳化小梁切除术与超声乳化iStent植入术的对比
Phaco-trabectome versus phaco-iStent in patients with open-angle glaucoma.
作者信息
Kurji Khaliq, Rudnisky Christopher J, Rayat Jaspreet S, Arora Sourabh, Sandhu Simrenjeet, Damji Karim F, Dorey Michael W
机构信息
Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta.
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.
出版信息
Can J Ophthalmol. 2017 Feb;52(1):99-106. doi: 10.1016/j.jcjo.2016.06.018. Epub 2016 Sep 7.
OBJECTIVE
To investigate efficacy and safety of phaco-trabectome (PT) versus phaco-iStent (Pi) for intraocular pressure (IOP) control in open-angle glaucoma (OAG).
DESIGN
Retrospective comparative case series.
PARTICIPANTS
A total of 70 eyes of 55 patients with OAG underwent either PT surgery by a single surgeon or Pi (insertion of 2 stents) by another surgeon in Canada between January 2010 and December 2012.
METHODS
The medical records of consecutive adult patients who underwent either PT or Pi surgery were reviewed. All patients who satisfied both the inclusion and exclusion criteria were included in the outcomes analyses. IOP reduction, reduction in glaucoma medication, safety profile, and best-corrected visual acuity were evaluated.
RESULTS
Thirty-six eyes of 30 patients had PT and 34 eyes of 25 patients had Pi. Baseline IOP was higher in the PT group (20.92 ± 5.07 mm Hg) than in the Pi group (17.47 ± 4.87 mm Hg; p = 0.026). At 12 months there was no significant difference between groups in relative reduction of mean IOP (PT -5.09 ± 5.73, 24% relative reduction vs. Pi -3.84 ± 3.80, 22% relative reduction; p = 0.331) or glaucoma medication use (PT -0.49 ± 1.17 vs. Pi -0.26 ± 0.73; p = 0.168) from baseline. However, Pi had significantly fewer individual complications (PT 20 vs. Pi 5; p < 0.0001) throughout the postoperative period.
CONCLUSION
At 12 months of follow-up, both techniques significantly lowered IOP, but fewer complications were observed in the Pi group.
目的
探讨超声乳化小梁切除术（PT）与超声乳化iStent植入术（Pi）在开角型青光眼（OAG）眼压（IOP）控制方面的疗效和安全性。
设计
回顾性比较病例系列研究。
研究对象
2010年1月至2012年12月期间，加拿大的55例OAG患者的70只眼睛，其中30例患者的36只眼睛由同一位外科医生进行PT手术，另外25例患者的34只眼睛由另一位外科医生进行Pi手术（植入2个支架）。
方法
回顾接受PT或Pi手术的成年连续患者的病历。所有符合纳入和排除标准的患者均纳入疗效分析。评估眼压降低情况、青光眼药物使用减少情况、安全性及最佳矫正视力。
结果
30例患者的36只眼睛接受了PT手术，25例患者的34只眼睛接受了Pi手术。PT组的基线眼压（20.92±5.07 mmHg）高于Pi组（17.47±4.87 mmHg；p = 0.026）。在12个月时，两组间平均眼压的相对降低幅度（PT组降低5.09±5.73，相对降低24%；Pi组降低3.84±3.80，相对降低22%；p = 0.331）或青光眼药物使用量（PT组降低0.49±1.17，Pi组降低0.26±0.73；p = 0.168）与基线相比均无显著差异。然而，在整个术后期间，Pi组的个体并发症明显更少（PT组20例，Pi组5例；p < 0.0001）。
结论
随访12个月时，两种技术均能显著降低眼压，但Pi组观察到的并发症更少。
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