Cutolo Carlo Alberto, Negri Letizia, Olivari Sara, Cappelli Francesca, Traverso Carlo Enrico, Iester Michele
Clinica Oculistica, Department of Neuroscience Rehabilitation Ophthalmology Genetics Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.
IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
J Ophthalmol. 2021 Mar 6;2021:6674505. doi: 10.1155/2021/6674505. eCollection 2021.
The purpose of this study is to estimate the incidence of choroidal detachment (CD) after XEN gel stent implant surgery and to evaluate the associated factors.
We reviewed the clinical charts of 126 patients who underwent XEN implantation between March 1, 2016, and December 31, 2018 at the University Eye Clinic of Genoa. Ocular, demographics, and perioperative factor were registered and analysed. Univariate and multivariate logistic analysis were performed to investigate factors associated with CD occurrence.
Of the 126 patients, 25 (19.8%) developed a choroidal detachment after XEN gel stent implant surgery. The mean period between surgery and CD detection was 5.84 ± 1.77 days. The mean intraocular pressure (IOP) at the time of CD diagnosis was 6.4 ± 3.1 mmHg. Age (OR = 1.10, < 0.019), early postoperative IOP (OR = 0.70, < 0.001), and number of preoperative IOP-lowering drugs (OR = 5.70, < 0.001) were significantly associated with CD presence. Complete resolution was observed in all the cases. Wide-field imaging and ultrasonography were useful tools to diagnose and follow up CD until resolution.
When carefully investigated, CD is a relatively common complication after XEN gel stent implant procedure. Older age, lower postoperative IOP, and higher number of preoperative IOP-lowering drugs were significantly associated with the development of CD.
本研究旨在评估XEN凝胶支架植入术后脉络膜脱离（CD）的发生率，并评估相关因素。
我们回顾了2016年3月1日至2018年12月31日在热那亚大学眼科诊所接受XEN植入术的126例患者的临床病历。记录并分析眼部、人口统计学和围手术期因素。进行单因素和多因素逻辑分析以研究与CD发生相关的因素。
126例患者中，25例（19.8%）在XEN凝胶支架植入术后发生脉络膜脱离。手术至CD检测的平均时间为5.84±1.77天。CD诊断时的平均眼压（IOP）为6.4±3.1 mmHg。年龄（OR = 1.10，P < 0.019）、术后早期IOP（OR = 0.70，P < 0.001）和术前降低IOP药物的数量（OR = 5.70，P < 0.001）与CD的存在显著相关。所有病例均观察到完全缓解。广角成像和超声检查是诊断和随访CD直至缓解的有用工具。
经仔细研究，CD是XEN凝胶支架植入术后相对常见的并发症。年龄较大、术后IOP较低以及术前降低IOP药物数量较多与CD的发生显著相关。
