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内路小梁切开联合房角成形术治疗人工晶状体眼开角型青光眼的短期疗效

Short-Term Efficacy of Combined ab Interno Canaloplasty and Trabeculotomy in Pseudophakic Eyes with Open-Angle Glaucoma.

作者信息

Bleeker Adam R, Litchfield William R, Ibach Mitch J, Greenwood Michael D, Ristvedt Deborah, Berdahl John P, Terveen Daniel C

机构信息

Dean McGee Eye Institute, Oklahoma City, OK, USA.

University of North Dakota School of Medicine, Grand Fords, ND, USA.

出版信息

Clin Ophthalmol. 2022 Jul 21;16:2295-2303. doi: 10.2147/OPTH.S367896. eCollection 2022.

Abstract

PURPOSE

To evaluate short-term outcomes of combined ab interno canaloplasty and trabeculotomy in pseudophakic eyes with open-angle glaucoma.

PATIENTS AND METHODS

Series included all pseudophakic eyes with open-angle glaucoma treated with up to 360° ab interno canaloplasty and up to 360° ab interno trabeculotomy using a purpose-engineered device (OMNI, Sight Sciences Inc). Data collected prior to surgery and out to 6-months postoperative. Surgical success defined as a 20% reduction in intraocular pressure (IOP) without increase in glaucoma medication, or discontinuation of at least one glaucoma medication without increase in IOP. Other primary endpoints included mean IOP and number of glaucoma medications.

RESULTS

The study included 67 eyes of 52 patients with a mean age of 76.5 ± 8.9 years. Preoperative mean IOP was 22.1±8.0 mmHg on 2.3±1.4 glaucoma medications. Pressure lowering effects were sustained out to 6 months postoperative with a mean IOP of 15.2±4.9 mmHg (p < 0.001) and mean medication reduction of 0.7±1.4 (p < 0.001). Surgical success rate was 69.8% (30 eyes) and correlated with preoperative IOP. Two patients required a secondary surgical intervention.

CONCLUSION

Combined ab interno canaloplasty and trabeculotomy as a standalone procedure is an effective means of reducing IOP and medication burden in pseudophakic eyes with open-angle glaucoma.

摘要

目的

评估内路小梁切开联合房角成形术治疗人工晶状体眼开角型青光眼的短期疗效。

患者和方法

该系列研究纳入了所有接受了使用特制设备(OMNI,Sight Sciences公司)进行的360°内路小梁切开联合360°内路房角成形术治疗的人工晶状体眼开角型青光眼患者。收集术前及术后6个月的数据。手术成功定义为眼压(IOP)降低20%且不增加青光眼药物用量,或至少停用一种青光眼药物且眼压不升高。其他主要终点包括平均眼压和青光眼药物使用数量。

结果

该研究纳入了52例患者的67只眼,平均年龄为76.5±8.9岁。术前平均眼压为22.1±8.0 mmHg,使用2.3±1.4种青光眼药物。术后6个月眼压降低效果持续存在,平均眼压为15.2±4.9 mmHg(p<0.001),平均药物使用减少0.7±1.4种(p<0.001)。手术成功率为69.8%(30只眼),且与术前眼压相关。2例患者需要二次手术干预。

结论

内路小梁切开联合房角成形术作为一种独立的手术方法,是降低人工晶状体眼开角型青光眼眼压和药物负担的有效手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb11/9317358/f0c908c4f311/OPTH-16-2295-g0001.jpg

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