Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.
Department of Ophthalmology and Vision Sciences, Royal Alexandra Hospital, Edmonton, Alta.
Can J Ophthalmol. 2018 Jun;53(3):246-251. doi: 10.1016/j.jcjo.2017.10.005. Epub 2017 Dec 1.
To evaluate and compare the surgeon's learning experience with an ab-interno gelatin microstent (XEN-45, Allergan) to other glaucoma surgeries.
Cross-sectional survey study.
All surgeons in Canada who used the gelatin microstent were identified and given an anonymous online survey (FluidSurveys, Survey Monkey) designed to evaluate key factors associated with the device, including prior surgical experience, patient selection criteria, analysis of each surgical step, and postoperative care. The survey was validated using input from 3 experienced glaucoma surgeons.
Surgeons were in early to mid-career (11.8 ± 7.2 operating years) and experienced with filtration surgery (94.1% very comfortable). Surgeons would more commonly operate on patients who had moderate to advanced disease (88.2% and 76.5% of surgeons felt appropriate to operate, respectively); had a diagnosis of primary open angle glaucoma or pseudoexfoliative glaucoma (70.6%); were on 2, 3, or 4 glaucoma medications (70.6%, 75.5%, 70.6%, respectively); and had previously undergone microinvasive glaucoma surgery (83.3%). Creation of the scleral tunnel into the subconjunctival space was rated the most difficult step of the surgery. Most surgeons (52.9%) required 6-10 cases to be comfortable with the procedure and felt it was easier to gain proficiency with ab-interno microstent implantation than traditional filtration surgery (94.1% agree or strongly agree).
The group of glaucoma surgeons surveyed felt it was easier to gain proficiency with gelatin microstent implantation than with traditional filtration surgery.
评估和比较外科医生使用内路明胶微支架（XEN-45，Allergan）的学习经验与其他青光眼手术。
横断面调查研究。
确定加拿大所有使用明胶微支架的外科医生，并向他们发放匿名在线调查（FluidSurveys，Survey Monkey），旨在评估与该设备相关的关键因素，包括先前的手术经验、患者选择标准、对每个手术步骤的分析以及术后护理。该调查经过 3 名经验丰富的青光眼外科医生的输入进行了验证。
外科医生处于职业生涯的早期到中期（11.8 ± 7.2 年手术经验），并且对滤过性手术有经验（94.1%非常舒适）。外科医生通常会对患有中度至晚期疾病的患者进行手术（分别有 88.2%和 76.5%的外科医生认为适合手术）；患有原发性开角型青光眼或假性剥脱性青光眼（70.6%）；正在使用 2、3 或 4 种青光眼药物（分别为 70.6%、75.5%、70.6%）；并且已经接受过微创青光眼手术（83.3%）。创建进入结膜下空间的巩膜隧道被评为手术中最困难的步骤。大多数外科医生（52.9%）需要 6-10 例手术才能对该手术感到舒适，并认为内路微支架植入比传统滤过性手术更容易获得熟练程度（94.1%同意或强烈同意）。
接受调查的青光眼外科医生组认为，与传统滤过性手术相比，更容易获得明胶微支架植入的熟练程度。
