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一次性使用双刃房角切开术:短期疗效。

Goniotomy with a single-use dual blade: Short-term results.

机构信息

From Vance Thompson Vision (Greenwood, Berdahl), Sioux Falls, South Dakota, the University of Colorado School of Medicine (Seibold), Aurora, Colorado, the New York Eye Surgery Center (Radcliffe), New York, New York, the Mayo Clinic (Dorairaj), Jacksonville and the Eye Institute (Darlington), Melbourne, Florida, the University of Illinois (Aref, Román), Chicago, Illinois, New World Medical, Inc. (Abdullah, Bahjri), Rancho Cucamonga, California, and B Through C, LLC (Jasek), Burleson, Texas, USA; Asociación para Evitar la Ceguera (Lazcano-Gomez), Mexico City, Mexico.

From Vance Thompson Vision (Greenwood, Berdahl), Sioux Falls, South Dakota, the University of Colorado School of Medicine (Seibold), Aurora, Colorado, the New York Eye Surgery Center (Radcliffe), New York, New York, the Mayo Clinic (Dorairaj), Jacksonville and the Eye Institute (Darlington), Melbourne, Florida, the University of Illinois (Aref, Román), Chicago, Illinois, New World Medical, Inc. (Abdullah, Bahjri), Rancho Cucamonga, California, and B Through C, LLC (Jasek), Burleson, Texas, USA; Asociación para Evitar la Ceguera (Lazcano-Gomez), Mexico City, Mexico.

出版信息

J Cataract Refract Surg. 2017 Sep;43(9):1197-1201. doi: 10.1016/j.jcrs.2017.06.046.

Abstract

PURPOSE

To evaluate the intraocular pressure (IOP)-lowering efficacy and safety of a single-use dual blade (Kahook) in patients with mild to end-stage glaucoma.

SETTING

International multicenter ophthalmic care centers.

DESIGN

Prospective interventional case series.

METHODS

Consecutive patients with glaucoma who had phacoemulsification plus goniotomy with the single-use dual blade were enrolled in this study. Each center collected deidentified clinical data, including preoperative and postoperative IOP, medication use, adverse events, and whether additional surgery was required during a 6-month follow-up.

RESULTS

Of the 71 eyes included in this study, 70% had primary open-angle glaucoma. Other diagnoses included angle-closure, pigmentary, pseudoexfoliative, and normal-tension glaucoma. Sixty-five percent of eyes were classified as having mild to moderate glaucoma and 35%, severe glaucoma. The mean baseline IOP decreased from 17.4 mm Hg ± 5.2 (SD) to 12.8 ± 2.6 mm Hg 6 months postoperatively and the hypotensive medication use decreased from 1.6 ± 1.3 to 0.9 ± 1.0, respectively (P < .001 and P = .005, respectively). The most common observation was blood reflux during surgery (39.4%).

CONCLUSION

Single-use dual blade goniotomy plus phacoemulsification resulted in a significant and sustained reduction in IOP and a decrease in glaucoma medications after 6 months of follow-up.

摘要

目的

评估一次性双刀片(Kahook)在轻度至晚期青光眼患者中的降眼压疗效和安全性。

设置

国际多中心眼科护理中心。

设计

前瞻性干预性病例系列。

方法

本研究纳入了接受超声乳化联合一次性双刀片房角切开术的青光眼连续患者。每个中心收集了匿名的临床数据,包括术前和术后眼压、药物使用、不良事件以及在 6 个月随访期间是否需要额外手术。

结果

本研究纳入了 71 只眼,其中 70%患有原发性开角型青光眼。其他诊断包括闭角型、色素性、剥脱性和正常眼压性青光眼。65%的眼被分类为轻度至中度青光眼,35%为重度青光眼。平均基线眼压从 17.4±5.2(SD)mmHg 降至术后 6 个月的 12.8±2.6mmHg(P<.001 和 P=.005),降压药物使用从 1.6±1.3 降至 0.9±1.0(P<.001 和 P=.005)。最常见的观察结果是手术期间出现血液反流(39.4%)。

结论

一次性双刀片房角切开术联合超声乳化术可显著持续降低眼压,并在 6 个月随访后减少青光眼药物的使用。

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