Meer Elana, Liu Tianyu, Hua Peiying, Ying Gui-Shuang, Miller Eydie, Lehman Amanda
Department of Ophthalmology, Scheie Eye Institute.
Perelman School of Medicine, University of Pennsylvania.
J Glaucoma. 2022 Jan 1;31(1):23-30. doi: 10.1097/IJG.0000000000001958.
This retrospective study characterized the efficacy and safety of 3 different microinvasive glaucoma surgery (MIGS) procedures in a predominantly African American population at the Philadelphia Veterans Affairs Hospital (Hydrus, Kahook, iStent), demonstrating no significant difference in intraocular pressure (IOP) and medication reduction between the 3 at long-term follow-up.
To compare the efficacy and safety of 3 different MIGS procedures in a predominantly African American population.
Retrospective cohort study of patients undergoing cataract extraction combined with 1 of 3 MIGS procedures (Hydrus, iStent, Kahook) at the Philadelphia Veterans Affairs Medical Center between January 1, 2015 and November 1, 2020. Analysis of variance and regression models were used to compare reduction in IOP and medication use among 3 MIGS types.
A total of 123 eyes of 112 patients were included, including 56 (45.5%) eyes for Hydrus, 40 (32.5%) eyes for iStent, and 27 (22.0%) eyes for Kahook. Adjusted mean IOP reduction was greater for Hydrus at postoperative day 1 (-4.49 vs. -1.76 for iStent and -1.69 for Kahook, P=0.05 and greater for Kahook at postoperative week 1 (-2.53 vs. +0.70 for iStent vs. -1.41 for Hydrus, P=0.02), but did not differ significantly between MIGS types at subsequent postoperative visits (all P>0.05). In multivariable analysis, MIGS type was not significantly associated with reduction in IOP or medication use at 9 to 12 months postoperatively. There were no significant differences in complication rates across MIGS types.
In this study, the difference in IOP lowering and medication reduction postoperatively between the Hydrus, iStent, and Kahook was not statistically significant after postoperative day 1. More studies are needed to evaluate outcomes of MIGS surgeries in glaucoma populations of different disease severity.
这项回顾性研究描述了在费城退伍军人事务医院（Hydrus、Kahook、iStent）以非裔美国人为主的人群中3种不同的微创青光眼手术（MIGS）的疗效和安全性，结果表明在长期随访中这3种手术在眼压（IOP）降低和药物减少方面无显著差异。
比较在以非裔美国人为主的人群中3种不同MIGS手术的疗效和安全性。
对2015年1月1日至2020年11月1日期间在费城退伍军人事务医疗中心接受白内障摘除术并联合3种MIGS手术（Hydrus、iStent、Kahook）之一的患者进行回顾性队列研究。采用方差分析和回归模型比较3种MIGS手术类型在眼压降低和药物使用方面的情况。
共纳入112例患者的123只眼，其中Hydrus组56只眼（45.5%），iStent组40只眼（32.5%），Kahook组27只眼（22.0%）。术后第1天Hydrus组的调整后平均眼压降低幅度更大（iStent组为-1.76，Kahook组为-1.69，P=0.05；Kahook组术后第1周更大（iStent组为+0.70，Hydrus组为-1.41，P=0.02），但在术后后续随访中3种MIGS手术类型之间无显著差异（所有P>0.05）。在多变量分析中，MIGS手术类型与术后9至12个月的眼压降低或药物使用减少无显著相关性。不同MIGS手术类型的并发症发生率无显著差异。
在本研究中，术后第1天之后，Hydrus、iStent和Kahook在眼压降低和药物减少方面的差异无统计学意义。需要更多研究来评估不同疾病严重程度的青光眼人群中MIGS手术的效果。
