Helmers Gloria, Munteanu Cristian, Löw Ursula, Seitz Berthold
Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Kirrberger Straße 100, Gebäude 22, 66424, Homburg/Saar, Deutschland.
Ophthalmologie. 2023 Jan;120(1):20-26. doi: 10.1007/s00347-022-01686-4. Epub 2022 Jul 13.
Trabeculectomy (TE) with mitomycin C (MMC) is considered the gold standard in glaucoma surgery. A new modification is the use of an Ologen® implant (AEON Astron Europe B.V., Leiden, Netherlands) during TE, which was analyzed and compared to the standard TE in this retrospective study.
On 70 eyes Ologen® was applied during surgery (group 2), whereas 98 eyes were operated on without the implant (group 1). Both surgical procedures were compared regarding the efficiency of lowering the intraocular pressure (IOP), the number of glaucoma medications, the rate of complications and follow-up treatment. Data were collected up to 24 months after surgery.
In group 1 the IOP was lowered from 28.0 mmHg (95% confidence interval, CI 26.6-29.4 mmHg) to 16.0 mmHg (14.0-18.1) after 24 months. In group 2, the pressure dropped from 28.5 mmHg (26.8-30.1) to 14.3 mmHg (11.7-17.0). The IOP reduction was significant in both groups (p < 0.001), there was no significant difference between the groups (p > 0.05). Glaucoma-related follow-up treatments were performed more often in group 1 but the difference was not significant.
Both procedures significantly lower the IOP and the number of glaucoma medications. For our cases, TE with Ologen® and MMC is considered to be superior to TE with MMC regarding the lower rates of follow-up treatments as it is less time-consuming for the patients and the clinic.
丝裂霉素C(MMC)小梁切除术(TE)被认为是青光眼手术的金标准。一种新的改良方法是在小梁切除术中使用Ologen®植入物(荷兰莱顿的AEON Astron Europe B.V.公司),在这项回顾性研究中对其进行了分析并与标准小梁切除术进行了比较。
70只眼睛在手术期间应用了Ologen®(第2组),而98只眼睛未使用植入物进行手术(第1组)。比较了两种手术在降低眼压(IOP)的效率、青光眼药物的使用数量、并发症发生率和后续治疗方面的情况。收集了手术至术后24个月的数据。
第1组术后24个月眼压从28.0 mmHg(95%置信区间,CI 26.6 - 29.4 mmHg)降至16.0 mmHg(14.0 - 18.1)。第2组眼压从28.5 mmHg(26.8 - 30.1)降至14.3 mmHg(11.7 - 17.0)。两组眼压降低均有显著意义(p < 0.001),两组之间无显著差异(p > 0.05)。第1组进行青光眼相关后续治疗的频率更高,但差异不显著。
两种手术均能显著降低眼压和青光眼药物的使用数量。对于我们的病例,使用Ologen®和MMC的小梁切除术在后续治疗率较低方面被认为优于使用MMC的小梁切除术,因为对患者和诊所来说耗时更少。