Department of Ophthalmology, Karşıyaka Eye Hospital, Caher Dudayev Bulv. No:71, 35550, İzmir, Turkey.
Int Ophthalmol. 2021 Mar;41(3):945-955. doi: 10.1007/s10792-020-01650-8. Epub 2020 Nov 12.
To report the effectiveness and safety of 5-fluorouracil (5-FU)-augmented Xen45 implantation in primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG).
This single-center, retrospective chart review study included 29 eyes that underwent 5-FU-augmented Xen45 implantation. Main outcome measures were intraocular pressure (IOP) levels and number of glaucoma medications. Surgical success was defined as IOP ≤ 21 mmHg and ≥ 20% reduction from preoperative levels without (complete success) or with (qualified success) glaucoma medications and without further glaucoma surgery at last follow-up. All postoperative interventions and complications were also noted.
The mean age of the patients was 67.5 ± 10.3 years, and the mean follow-up time was 23.2 ± 12.6 months. Mean IOP was 24.5 ± 8.7 mmHg and decreased by 30.2% at 12 months, 24.9% at 24 months, and 31.7% at final visit (p < 0.001, p = 0.006, p > 0.001, respectively). Mean number of glaucoma medications decreased from 2.83 preoperatively to 0.71 at 12 months, 0.87 at 24 months, and 0.86 at final visit (p < 0.001). At final visit, the complete success rate was 48.3%, qualified success rate was 69%, and 62.1% of the eyes were free of glaucoma medications. Needling was performed in 7 eyes (24%). Adverse events included choroidal detachment in 5 eyes, hyphema in 2 eyes, and endophthalmitis in 1 eye.
5-FU-augmented Xen45 implantation in POAG and PEXG patients provided safe and effective IOP lowering with significant reduction of glaucoma medications up to 3 years.
报告在原发性开角型青光眼(POAG)和假性剥脱性青光眼(PEXG)中应用 5-氟尿嘧啶(5-FU)增强 Xen45 植入物的有效性和安全性。
这是一项单中心回顾性图表研究,共纳入 29 只眼行 5-FU 增强 Xen45 植入术。主要观察指标为眼内压(IOP)水平和青光眼药物使用数量。手术成功定义为 IOP≤21mmHg,且较术前水平降低≥20%,无需(完全成功)或需(部分成功)使用降眼压药物,且末次随访时无需进一步行青光眼手术。同时记录所有术后干预和并发症。
患者的平均年龄为 67.5±10.3 岁,平均随访时间为 23.2±12.6 个月。平均 IOP 为 24.5±8.7mmHg,术后 12 个月时降低了 30.2%,24 个月时降低了 24.9%,末次随访时降低了 31.7%(p<0.001,p=0.006,p>0.001)。平均青光眼药物使用数量从术前的 2.83 种减少至术后 12 个月时的 0.71 种、24 个月时的 0.87 种和末次随访时的 0.86 种(p<0.001)。末次随访时,完全成功率为 48.3%,部分成功率为 69%,62.1%的眼无需使用青光眼药物。7 只眼(24%)行针拨术。不良反应包括 5 只眼出现脉络膜脱离、2 只眼出现前房积血和 1 只眼发生眼内炎。
在 POAG 和 PEXG 患者中应用 5-FU 增强 Xen45 植入物可安全有效地降低 IOP,且 3 年内显著减少青光眼药物的使用。