Eastern Virginia Medical School, Norfolk, VA.
Johns Hopkins University School of Medicine.
J Glaucoma. 2023 Sep 1;32(9):769-776. doi: 10.1097/IJG.0000000000002245. Epub 2023 May 25.
Compared with phacoemulsification and microstent alone, we observed that phacoemulsification with combined microstent and canaloplasty resulted in a significantly greater reduction in glaucoma medications while maintaining similar rates of intraocular pressure reduction and low complications.
The purpose of this study was to compare the outcomes of phacoemulsification combined with Hydrus Microstent (Alcon Inc.) implantation alone or in combination with canaloplasty (OMNI Surgical System, Sight Sciences Inc.).
Retrospective study of mild-to-moderate primary open angle glaucoma patients who underwent phacoemulsification with microstent alone (42 eyes of 42 patients) or in combination with canaloplasty (canaloplasty-microstent, 32 eyes of 32 patients). The mean number of ocular hypotensive medications and intraocular pressure were assessed preoperatively and postoperatively at 1 week and at 1, 3, and 6 months. Complications and secondary surgical interventions were recorded. Outcomes measures included the percentage of unmedicated eyes and surgical success at 6 months. Surgical success was defined as reaching the target intraocular pressure without medications or secondary surgical interventions.
Mean intraocular pressure at 6 months was 14.1±3.5 mm Hg (13% reduction) after microstent alone and 13.6±3.1 mm Hg (17% reduction) after canaloplasty-microstent. Mean medications at 6 months were 0.57±0.9 (67% reduction) after microstent alone and 0.16±0.4 (88% reduction) after canaloplasty-microstent ( P< 0.05). At 6 months, 64.3% of microstent alone and 87.3% of canaloplasty-microstent were off all medications ( P =0.02). Success probabilities at 6 months were 44.5% for microstent alone and 70.0% for canaloplasty-microstent ( P =0.04). No secondary surgical interventions occurred in either group.
Microstent combined with canaloplasty resulted in a significantly higher rate of medication-free status compared with microstent alone through 6 months.
与单纯超声乳化白内障吸除术和微支架植入术相比，我们发现联合应用超声乳化白内障吸除术、微支架和房水引流管植入术治疗青光眼可显著减少降眼压药物的使用，同时保持相似的眼压降低率和较低的并发症发生率。
本研究旨在比较单纯应用超声乳化白内障吸除术联合 Hydrus 微支架（爱尔康公司）植入术（42 眼，42 例）或联合房水引流管植入术（OMNI 手术系统，Sight Sciences 公司）治疗青光眼的效果。
回顾性研究轻度至中度原发性开角型青光眼患者，这些患者均接受了超声乳化白内障吸除术联合微支架植入术（单纯微支架植入术，42 眼，42 例）或联合房水引流管植入术（微支架联合房水引流管植入术，32 眼，32 例）。评估术前、术后 1 周、1、3 和 6 个月时的平均降眼压药物使用数量和眼压。记录并发症和二次手术干预情况。观察指标包括术后 6 个月时的无药眼比例和手术成功率。手术成功定义为无需药物或二次手术干预即可达到目标眼压。
单纯微支架植入术后 6 个月时的平均眼压为 14.1±3.5mmHg（降低 13%），微支架联合房水引流管植入术后为 13.6±3.1mmHg（降低 17%）。单纯微支架植入术后 6 个月时的平均用药数量为 0.57±0.9（降低 67%），微支架联合房水引流管植入术后为 0.16±0.4（降低 88%）（ P<0.05）。术后 6 个月时，单纯微支架植入术组 64.3%的患者无需药物治疗，微支架联合房水引流管植入术组 87.3%的患者无需药物治疗（ P=0.02）。单纯微支架植入术组的 6 个月手术成功率为 44.5%，微支架联合房水引流管植入术组为 70.0%（ P=0.04）。两组均未发生二次手术干预。
与单纯微支架植入术相比，微支架联合房水引流管植入术在 6 个月时可显著提高药物豁免率。
