Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.
Cardinal Santos Medical Centre, San Juan, Metro Manila, Philippines.
Eur J Ophthalmol. 2022 Jan;32(1):288-295. doi: 10.1177/11206721211000641. Epub 2021 Mar 21.
To evaluate the safety and efficacy of the iStent inject device combined with phacoemulsification in Asian eyes with primary open angle glaucoma.
A retrospective study of combined phacoemulsification and iStent inject surgeries performed in a single institution from July 2017 to August 2019 on patients with co-existing cataracts and primary open angle glaucoma (POAG). Outcome measures included best-corrected visual acuity, intraocular pressure (IOP), number of glaucoma eyedrop medications, and surgical complications.
A total of 95 eyes were included. Majority of subjects were male (59, 62.1%) and Chinese (83, 87.4%). Mean age was 74.7 ± 8.7 years. Pre-operatively, mean IOP was 16.2 ± 4.3 mmHg and number of medications was 1.9 ± 0.9. Significant post-operative reduction in mean IOP was observed at all timepoints - post-operative month (POM)1: 3.0 ± 5.6 mmHg reduction ( = 95, < 0.05); POM3: 1.6 ± 3.8 mmHg ( = 66, < 0.05); POM6: 1.8 ± 4.7 mmHg ( = 55, < 0.05); POM12: 1.3 ± 4.2 mmHg ( = 48) ( < 0.05). The number of glaucoma medications was also reduced from a mean of 1.9 ± 0.8 to 0.6 ± 1.0 at POM12 ( < 0.05). Intraoperatively, one case of malignant glaucoma occurred. Post operatively, implant obstruction by iris was observed in two eyes post-operatively requiring iridoplasty. One case of cystoid macular edema and one case of drop in visual acuity due to glaucoma progression was/were also observed.
Asian eyes undergoing combined phacoemulsification and iStent inject surgery demonstrate a significant and sustained reduction in both IOP and number of glaucoma medications. Overall, there is a good safety profile for iStent inject.
评估 iStent inject 装置在亚洲原发性开角型青光眼合并白内障患者中行超声乳化白内障吸除术联合治疗的安全性和有效性。
回顾性研究 2017 年 7 月至 2019 年 8 月期间在一家医疗机构接受超声乳化白内障吸除术联合 iStent inject 手术的合并白内障和原发性开角型青光眼（POAG）的患者。观察指标包括最佳矫正视力、眼内压（IOP）、青光眼滴眼液药物数量和手术并发症。
共纳入 95 只眼。多数患者为男性（59 例，62.1%）和中国人（83 例，87.4%）。平均年龄为 74.7±8.7 岁。术前平均 IOP 为 16.2±4.3mmHg，药物治疗数量为 1.9±0.9。术后所有时间点的 IOP 均显著降低：术后 1 个月（POM1）：下降 3.0±5.6mmHg（=95， <0.05）；术后 3 个月（POM3）：下降 1.6±3.8mmHg（=66， <0.05）；术后 6 个月（POM6）：下降 1.8±4.7mmHg（=55， <0.05）；术后 12 个月（POM12）：下降 1.3±4.2mmHg（=48， <0.05）。青光眼药物治疗数量也从术前的 1.9±0.8 减少到术后 12 个月的 0.6±1.0（=48， <0.05）。术中发生 1 例恶性青光眼。术后 2 只眼发生虹膜阻塞性植入物阻塞，需要行虹膜切开术。术后还观察到 1 例黄斑囊样水肿和 1 例因青光眼进展导致视力下降。
亚洲人在接受超声乳化白内障吸除术联合 iStent inject 手术后，IOP 和青光眼药物治疗数量均显著且持续降低。总体而言，iStent inject 的安全性良好。
