Rho Seungsoo, Lim Su-Ho
Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
Department of Ophthalmology, Daegu Veterans Health Service Medical Center, #60 Wolgok-Ro, Dalseo-Gu, Daegu, 42835, South Korea.
Ophthalmol Ther. 2021 Dec;10(4):1105-1117. doi: 10.1007/s40123-021-00412-8. Epub 2021 Oct 26.
To evaluate the intraocular pressure (IOP)-lowering effect of second-generation trabecular microbypass stents (iStent® inject) with cataract extraction (combination group) and compare refractive changes in the combination group and the control (phacoemulsification only) group.
This retrospective case-control study included 36 eyes with cataract and medically controlled open-angle glaucoma with IOP < 21 mmHg and 100 nonglaucomatous eyes with cataract. Data were collected preoperatively and for 6 months postoperatively. Data included IOP, number of glaucoma medications, corrected distance visual acuity, and mean absolute error (MAE) from target refraction, and astigmatic vector analysis. Surgical success for the combination group was defined according to three criteria: (A) IOP < 15 mmHg without medication, (B) IOP < 18 mmHg without medication, and (C) IOP < 18 mmHg with or without medication.
In the combination group, mean IOP was reduced from 15.1 ± 2.9 mmHg to 12.5 ± 2.0 mmHg, and the mean number of medications decreased from 1.9 ± 1.0 to 0.4 ± 0.8 at postoperative 6 months (both P < 0.001). Surgical success rates were 77.8%, 83.3%, and 97.2% at 6 months by criteria A, B, and C, respectively. Mean IOP was reduced from 14.3 ± 2.7 mmHg to 13.1 ± 2.1 mmHg at 1 month in the control group (P < 0.001). The MAE was 0.33 ± 0.26 D, and 83.3% of eyes had spherical equivalent difference within 0.50 D in the combination group (0.38 ± 0.33 D and 76.0% in the control group; P = 0.309 and P = 0.363, respectively). Preoperative and postoperative centroid values were 0.51 D @ 1° and 0.66 D @ 178°, respectively (0.23 D @ 176° and 0.66 D @ 1° in the control group). There were no statistical differences between the two groups with respect to preoperative and postoperative mean absolute values (P = 0.154 and P = 0.322, respectively).
On the basis of our results using Korean real-world interim experience, iStent® inject with cataract extraction has favorable IOP-lowering effects and minimally impacts refractive outcomes.
评估第二代小梁微旁路支架（iStent® inject）联合白内障摘除术的降眼压效果（联合组），并比较联合组与对照组（单纯超声乳化术组）的屈光变化。
这项回顾性病例对照研究纳入了36例患有白内障且眼压通过药物控制在21 mmHg以下的开角型青光眼患者的眼睛，以及100例非青光眼性白内障患者的眼睛。在术前及术后6个月收集数据。数据包括眼压、青光眼药物使用数量、矫正远视力、与目标屈光的平均绝对误差（MAE）以及散光矢量分析。联合组的手术成功根据以下三个标准定义：（A）不用药时眼压<15 mmHg；（B）不用药时眼压<18 mmHg；（C）用药或不用药时眼压<18 mmHg。
联合组中，平均眼压从15.1±2.9 mmHg降至术后6个月时的12.5±2.0 mmHg，平均药物使用数量从1.9±1.0降至0.4±0.8（均P<0.001）。按照标准A、B和C，6个月时的手术成功率分别为77.8%、83.3%和97.2%。对照组在术后1个月时平均眼压从14.3±2.7 mmHg降至13.1±2.1 mmHg（P<0.001）。联合组的MAE为0.33±0.26 D，83.3%的眼睛等效球镜度差异在0.50 D以内（对照组为0.38±0.33 D和76.0%；P分别为0.309和0.363）。术前和术后的质心值分别为0.51 D @ 1°和0.66 D @ 178°（对照组为0.23 D @ 176°和0.66 D @ 1°）。两组在术前和术后平均绝对值方面无统计学差异（P分别为0.154和0.322）。
基于我们使用韩国真实世界中期经验的结果，iStent® inject联合白内障摘除术具有良好的降眼压效果，且对屈光结果影响极小。
