Swiss Federal Institute of Technology.
Glaucoma Center, Montchoisi Clinic, Lausanne.
J Glaucoma. 2020 May;29(5):401-405. doi: 10.1097/IJG.0000000000001471.
To assess the efficacy and safety of a glaucoma procedure to control intraocular pressure (IOP) using the adjustable eyeWatch glaucoma drainage device compared with Ahmed glaucoma valve (AGV) in refractory glaucoma.
Monocentric, retrospective, comparative clinical trial. Patients suffering from refractory glaucoma after failed surgeries and requiring a further glaucoma procedure including an aqueous shunt were enrolled in this study. The first group AGV included patients with an AGV. The second group eW-B included patients receiving an eyeWatch used in connection with a Baerveldt glaucoma implant. The primary outcome was the success rate, defined as an IOP≤16 mm Hg and reduction of >20% from baseline, and IOP≥5 mm Hg. Secondary outcomes were mean IOP, number of antiglaucoma medications, visual acuity, number and type of complications.
Twenty-one patients were included. The mean follow-up time was 13.2±3.4 months. Mean IOP decreased from 24.8±9.0 mm Hg before surgery to 13.8±3.6 mm Hg at 12 months for group AGV, and 27.3±7.0 to 12.8±2.4 mm Hg for group eW-B, respectively (P<0.05). Mean number of glaucoma medications decreased from 3.0±0.7 before surgery to 0.3±0.7 at last control for group AGV, and 2.9±0.8 before surgery to 0.2±0.4 for group eW-B, respectively (P<0.05). The complete and overall success rates were 50% and 58% for group AGV, and 67% and 89% for group eW-B, respectively.
The postoperative adjustability of the eyeWatch is believed to help with getting fewer complications and better IOP management whereas AGV cannot be adjusted postoperatively.
评估可调节的眼 Watch 青光眼引流装置在难治性青光眼中控制眼内压（IOP）的疗效和安全性，与 Ahmed 青光眼阀（AGV）相比。
单中心、回顾性、对照临床试验。患有失败手术后难治性青光眼并需要进一步青光眼手术（包括房水分流术）的患者被纳入本研究。AGV 组包括接受 AGV 的患者，eW-B 组包括接受与 Baerveldt 青光眼植入物联合使用的眼 Watch 的患者。主要结局是成功率，定义为 IOP≤16mmHg 且较基线降低>20%，以及 IOP≥5mmHg。次要结局是平均 IOP、抗青光眼药物数量、视力、并发症的数量和类型。
共纳入 21 例患者，平均随访时间为 13.2±3.4 个月。AGV 组手术前平均 IOP 为 24.8±9.0mmHg，手术后 12 个月为 13.8±3.6mmHg，eW-B 组手术前平均 IOP 为 27.3±7.0mmHg，手术后 12 个月为 12.8±2.4mmHg，两组均有统计学差异（P<0.05）。AGV 组手术前平均抗青光眼药物数量为 3.0±0.7 种，最后一次随访时为 0.3±0.7 种，eW-B 组手术前平均抗青光眼药物数量为 2.9±0.8 种，最后一次随访时为 0.2±0.4 种，两组均有统计学差异（P<0.05）。AGV 组完全成功率和总成功率分别为 50%和 58%，eW-B 组分别为 67%和 89%。
眼 Watch 的术后可调节性被认为有助于减少并发症和更好地管理 IOP，而 AGV 术后无法调节。
