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新型眼科黏弹剂输送装置的安全性和有效性:随机对照研究。

Safety and effectiveness of a new ophthalmic viscosurgical device: randomized, controlled study.

机构信息

From the Mark Packer MD Consulting, Inc., Boulder, Colorado (Packer); Vance Thompson Vision, Sioux Falls, South Dakota (Berdahl); Wolstan & Goldberg Eye Associates, Torrance, California (Goldberg); Bausch & Lomb Surgical, Bridgewater, New Jersey (Hosten, Lau).

出版信息

J Cataract Refract Surg. 2022 Sep 1;48(9):1050-1056. doi: 10.1097/j.jcrs.0000000000000904. Epub 2022 Feb 8.

Abstract

PURPOSE

To evaluate the safety and effectiveness of a new dispersive ophthalmic viscosurgical device (OVD) (ClearVisc) compared with an approved dispersive OVD (Viscoat) when used in cataract surgery.

SETTING

16 clinics in the United States.

DESIGN

Prospective multicenter controlled randomized 1:1 (ClearVisc:Viscoat; stratified by site, age group, and cataract severity). Patients and examiners masked.

METHODS

Patients aged 45 years or older with age-related noncomplicated cataract considered amenable to treatment with standard phacoemulsification cataract extraction and intraocular lens (IOL) implantation were included. Patients were randomized to receive either ClearVisc or Viscoat using standard techniques. 5 postoperative visits occurred at 6 hours, 24 hours, 7 days, 1 month, and 3 months. The primary effectiveness outcome was the change in endothelial cell density (ECD) from baseline to 3 months. The primary safety end point was the proportion of patients who experienced at least 1 intraocular pressure (IOP) measurement ≥30 mm Hg at any follow-up visit. Noninferiority was tested. Inflammation and adverse events were evaluated.

RESULTS

372 patients were randomized: 184 patients in the ClearVisc group and 188 patients in the Viscoat group. ClearVisc was noninferior to Viscoat in mean percentage of ECD loss from baseline to 3 months (8.4% and 6.8%, respectively). ClearVisc was significantly noninferior to Viscoat in the proportion of patients with postoperative IOP ≥30 mm Hg at any follow-up visit (17.4% and 20.3%, respectively, P = .0002).

CONCLUSIONS

ClearVisc dispersive OVD provides surgeons with a new option in the continuum of approved dispersive OVDs with beneficial properties as a surgical aid in cataract extraction and IOL implantation.

摘要

目的

评估一种新型亲水性眼用粘弹剂(OVD)(ClearVisc)在白内障手术中的安全性和有效性,与已批准的亲水性 OVD(Viscoat)进行比较。

设置

美国 16 个诊所。

设计

前瞻性多中心对照随机 1:1(ClearVisc:Viscoat;按地点、年龄组和白内障严重程度分层)。患者和检查者均设盲。

方法

纳入年龄在 45 岁及以上、患有年龄相关性非复杂性白内障且适合标准超声乳化白内障吸除术和人工晶状体(IOL)植入术治疗的患者。患者按标准技术随机接受 ClearVisc 或 Viscoat 治疗。术后 6 小时、24 小时、7 天、1 个月和 3 个月进行 5 次随访。主要有效性结局是从基线到 3 个月时内皮细胞密度(ECD)的变化。主要安全性终点是在任何随访时至少有 1 次眼压(IOP)测量值≥30mmHg 的患者比例。进行非劣效性检验。评估炎症和不良事件。

结果

共 372 例患者随机分组:ClearVisc 组 184 例,Viscoat 组 188 例。ClearVisc 在从基线到 3 个月时 ECD 损失的平均百分比方面不劣于 Viscoat(分别为 8.4%和 6.8%)。ClearVisc 在任何随访时IOP≥30mmHg 的患者比例方面显著优于 Viscoat(分别为 17.4%和 20.3%,P=0.0002)。

结论

ClearVisc 亲水性 OVD 为外科医生提供了一种新的选择,作为白内障摘除和 IOL 植入手术中的辅助手段,它具有批准的亲水性 OVD 的有益特性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d860/9415196/94fcc917a33f/jcrs-48-1050-g001.jpg

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