Schargus Marc, Busch Catharina, Rehak Matus, Meng Jie, Schmidt Manuela, Bormann Caroline, Unterlauft Jan Darius
Universitäts-Augenklinik Düsseldorf, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
Department of Ophthalmology, Asklepios Klnik Nord-Heidberg, Tangstedter Landstrasse 400, 22417 Hamburg, Germany.
Biology (Basel). 2021 Mar 27;10(4):273. doi: 10.3390/biology10040273.
The aim of this study was to compare the efficacy of trabeculectomy (TE), single XEN microstent implantation (solo XEN) or combined XEN implantation and cataract surgery (combined XEN) in primary open-angle glaucoma cases, naïve to prior surgical treatment, using a monocentric retrospective comparative cohort study. Intraocular pressure (IOP) and the number of IOP-lowering drugs (Meds) were monitored during the first 24 months after surgery. Further disease progression was monitored using peripapillary retinal nerve fiber layer (RNFL) thickness examinations using spectral domain optical coherence tomography (OCT) as well as visual acuity (VA) and visual field (VF) tests. In the TE group (52 eyes), the mean IOP decreased from 24.9 ± 5.9 to 13.9 ± 4.2 mmHg ( 0.001) and Meds decreased from 3.2 ± 1.2 to 0.5 ± 1.1 ( 0.001). In the solo XEN (38 eyes) and the combined XEN groups, the mean IOP decreased from 24.1 ± 4.7 to 15.7 ± 3.0 mmHg ( 0.001) and 25.4 ± 5.6 to 14.7 ± 3.2 mmHg ( 0.001), while Meds decreased from 3.3 ± 0.8 to 0.8 ± 1.2 ( 0.001) and 2.7 ± 1.2 to 0.4 ± 1.0 ( 0.001), respectively. The VF and VA indices showed no sign of further deterioration, the RNFL thickness further decreased in all treatment groups after surgery. TE and XEN led to comparable reductions in IOP and Meds. Although the VA and VF indices remained unaltered, the RNFL thickness continuously decreased in all treatment groups during the 24-month follow-up.
本研究的目的是采用单中心回顾性比较队列研究，比较小梁切除术（TE）、单枚XEN微支架植入术（单枚XEN）或XEN植入联合白内障手术（联合XEN）在未经手术治疗的原发性开角型青光眼患者中的疗效。在术后的前24个月监测眼压（IOP）和降眼压药物（Meds）的使用数量。使用频域光学相干断层扫描（OCT）进行视乳头周围视网膜神经纤维层（RNFL）厚度检查以及视力（VA）和视野（VF）测试，以监测疾病的进一步进展。在TE组（52只眼）中，平均眼压从24.9±5.9降至13.9±4.2 mmHg（P<0.001），Meds从3.2±1.2降至0.5±1.1（P<0.001）。在单枚XEN组（38只眼）和联合XEN组中，平均眼压分别从24.1±4.7降至15.7±3.0 mmHg（P<0.001）和从25.4±5.6降至14.7±3.2 mmHg（P<0.001），而Meds分别从3.3±0.8降至0.8±1.2（P<0.001）和从2.7±1.2降至0.4±1.0（P<0.001）。VF和VA指标未显示进一步恶化的迹象，术后所有治疗组的RNFL厚度均进一步降低。TE和XEN在降低IOP和Meds方面效果相当。尽管VA和VF指标保持不变，但在24个月的随访期间，所有治疗组的RNFL厚度持续下降。
