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亚洲正常眼压性青光眼患者超声乳化白内障吸除联合 iStent 注射术后 12 个月的疗效观察:单中心经验

12-Month Outcomes of Combined Phacoemulsification and iStent Inject in Asian Eyes with Normal Tension Glaucoma: A Single-Centre Experience.

机构信息

Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore, Singapore.

Department of Ophthalmology, Woodlands Health Campus, National Healthcare Group Eye Institute, Singapore, Singapore.

出版信息

Int Ophthalmol. 2022 Feb;42(2):611-620. doi: 10.1007/s10792-021-02033-3. Epub 2021 Oct 15.

Abstract

PURPOSE

To evaluate efficacy and safety of the iStent inject combined with phacoemulsification in Asian eyes with normal-tension glaucoma (NTG) up to 12 months after surgery.

STUDY DESIGN

Retrospective case series.

METHODS

Retrospective case series of eyes undergoing surgery from April 2017 to August 2019. Outcome measures included intraocular pressure (IOP), number of topical glaucoma medications and adverse outcomes. Data were retrieved from the post-operative day 1 (POD1), week 1 (POW1), month 1 (POM1), month 3 (POM3), month 6 (POM6) and month 12 (POM12) timepoints. Data were analysed at each timepoint for eyes with available clinical data at that visit. Subgroup analysis was performed for a consistent cohort which included only eyes with data at all six follow-up timepoints.

RESULTS

Data from 91 eyes in the collective subject group was analysed. Majority of subjects were male (53, 58.2%) and Chinese (79, 86.8%). Mean age was 73.2 ± 7.2 years. Pre-operatively, mean IOP was 14.3 ± 3.0 mmHg and mean number of medications was 1.5 ± 0.8. Significant IOP reduction was observed at all timepoints except POW1 and POM12. The number of medications was reduced at all timepoints (p < 0.001). By POM12, there was reduction of 1.2 ± 1.0 medications (p < 0.001). Both the collective and consistent cohorts demonstrated a trend towards decreasing surgical efficacy with time, in IOP reduction and decrease in medications. None of the eyes experienced sight-threatening complications.

CONCLUSIONS

Asian eyes with NTG undergoing combined phacoemulsification and iStent inject surgery demonstrated significant and sustained reduction in number of glaucoma medications up to 12 months post-operatively.

摘要

目的

评估 iStent inject 在亚洲正常眼压性青光眼(NTG)眼中的疗效和安全性,随访时间至术后 12 个月。

研究设计

回顾性病例系列。

方法

回顾性病例系列,纳入 2017 年 4 月至 2019 年 8 月期间行手术的患者。观察指标包括眼内压(IOP)、局部降眼压药物的使用数量和不良事件。术后第 1 天(POD1)、第 1 周(POW1)、第 1 个月(POM1)、第 3 个月(POM3)、第 6 个月(POM6)和第 12 个月(POM12)收集相关数据。分析各个时间点可获得临床数据的眼的情况。对于在所有 6 次随访时间点都有数据的一致性队列进行亚组分析。

结果

对 91 只眼的总体数据进行分析。大多数患者为男性(53 只,58.2%)和中国人(79 只,86.8%)。平均年龄为 73.2±7.2 岁。术前,平均 IOP 为 14.3±3.0mmHg,平均用药数为 1.5±0.8。除 POW1 和 POM12 外,所有时间点的 IOP 均显著降低。所有时间点的药物使用数量均减少(p<0.001)。POM12 时,药物减少 1.2±1.0 种(p<0.001)。无论是总体队列还是一致性队列,IOP 降低和药物减少的手术效果都随时间呈下降趋势。无任何眼发生威胁视力的并发症。

结论

亚洲 NTG 患者行超声乳化白内障吸除术联合 iStent inject 手术,术后 12 个月内,降眼压药物的使用数量显著且持续减少。

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