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单中心非随机研究中PRESERFLO微型分流器治疗原发性开角型青光眼患者的长期结果

Long-term Results of the PRESERFLO MicroShunt in Patients With Primary Open-angle Glaucoma From a Single-center Nonrandomized Study.

作者信息

Batlle Juan F, Corona Adalgisa, Albuquerque Rachel

机构信息

Laser Center, Santo Domingo, Dominican Republic.

出版信息

J Glaucoma. 2021 Mar 1;30(3):281-286. doi: 10.1097/IJG.0000000000001734.

Abstract

PRECIS

The MicroShunt was implanted in 23 patients with primary open-angle glaucoma (POAG) in a feasibility study. Reductions in intraocular pressure (IOP) and medications were sustained for up to 5 years with no long-term sight-threatening adverse events (AEs).

PURPOSE

The purpose of this study was to assess the long-term effectiveness and safety of the PRESERFLO MicroShunt (8.5 mm long, 70 µm lumen surgical device, formerly known as the InnFocus MicroShunt) in POAG.

PATIENTS AND METHODS

In a feasibility study (NCT00772330), patients with POAG inadequately controlled on maximum tolerated therapy with IOP ≥18 to ≤40 mm Hg underwent MicroShunt implantation with adjunctive mitomycin C (0.4 mg/mL), alone or in combination with cataract surgery. Years 1 to 3 findings have previously been reported. Endpoints of this extension study included IOP reduction and success at years 4 and 5 (primary), incidence of AEs, medication use, and reoperations.

RESULTS

Mean IOP was reduced from 23.8±5.3 mm Hg at baseline to 12.8±5.6 mm Hg (year 4; n=21) and 12.4±6.5 mm Hg (year 5; n=21). Overall success (with/without medication use) was 87.0% (year 4) and 82.6% (year 5). The mean number of medications reduced from 2.4±1.0 at baseline to 0.8±1.3 (year 5). Common (≥5% of patients) AEs included corneal edema (n=4), transient hypotony (n=4), bleb-related complications (n=3), and device touching the iris (n=3). There were 4 reports of serious AEs and 2 reoperations.

CONCLUSIONS

In this extension study, sustained reductions in mean IOP and medications were observed up to 5 years post-MicroShunt implantation. There were no reports of long-term sight-threatening AEs and a low rate of postoperative interventions.

摘要

摘要

在一项可行性研究中,23例原发性开角型青光眼(POAG)患者植入了MicroShunt。眼压(IOP)降低及药物使用量减少的效果持续了长达5年,且未出现长期威胁视力的不良事件(AE)。

目的

本研究旨在评估PRESERFLO MicroShunt(8.5毫米长,70微米内腔手术装置,前身为InnFocus MicroShunt)用于POAG的长期有效性和安全性。

患者与方法

在一项可行性研究(NCT00772330)中,接受最大耐受治疗后眼压仍控制不佳(IOP≥18至≤40毫米汞柱)的POAG患者接受了MicroShunt植入术,并辅助使用丝裂霉素C(0.4毫克/毫升),单独使用或与白内障手术联合使用。第1至3年的研究结果此前已报告。本扩展研究的终点包括第4年和第5年的眼压降低情况及成功率(主要终点)、AE发生率、药物使用情况和再次手术情况。

结果

平均眼压从基线时的23.8±5.3毫米汞柱降至第4年的12.8±5.6毫米汞柱(n = 21)和第5年的12.4±6.5毫米汞柱(n = 21)。总体成功率(无论是否使用药物)在第4年为87.0%,第5年为82.6%。平均药物使用量从基线时的2.4±1.0降至第5年的0.8±1.3。常见(≥5%的患者)AE包括角膜水肿(n = 4)、短暂性低眼压(n = 4)、滤过泡相关并发症(n = 3)和装置接触虹膜(n = 3)。有4例严重AE报告和2例再次手术。

结论

在本扩展研究中,MicroShunt植入术后长达5年观察到平均眼压和药物使用量持续降低。未报告长期威胁视力的AE,术后干预率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca26/8041565/ec5561ab2d3b/ijg-30-281-g001.jpg

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