Vizzari Gabriele, Ceruti Piero
Department of Ophthalmology, Hospital Mater Salutis Legnago, Legnago, Verona, Italy.
Eur J Ophthalmol. 2025 Mar;35(2):568-575. doi: 10.1177/11206721241272224. Epub 2024 Aug 6.
To describe the results of iStent implantation as a standalone procedure in early-stage uncontrolled glaucoma, with results up to 24 months.
A retrospective, single-center case series that recruited patients with open-angle glaucoma (OAG), uncontrolled IOP (defined as ≥18 mmHg), and who are receiving 1-4 glaucoma medications were implanted the iStent as a standalone procedure. Exclusion criteria were the contraindications of iStent implantation. Primary outcome measures were IOP at 6, 12, 18, and 24 months compared to baseline, and the number of medications at baseline and 24 months.
Eighty-eight eyes from 88 patients, aged 57.6 ± 9.8 years, were included. Ten eyes underwent a subsequent glaucoma procedure during follow-up and were excluded from the analysis. The mean IOP (mmHg) was reduced from 20.54 ± 1.42 at baseline to 15.99 ± 1.98 and 16.15 ± 2.21 (n = 78, p < 0.001) at the 12- and 24-month follow-up, respectively, and the mean number of medications was reduced from 2.35 ± 0.70 to 1.31 ± 0.80 (p < 0.001) at 24 months. Of those eyes, 59% had ≥20% reduction in IOP at 24 months, 91% had an IOP ≤18 mmHg at 24 months, and 71.8% were receiving fewer medications. At 24 months, 14.1% of eyes were medication-free, compared to none at baseline. No serious intraoperative or postoperative adverse events occurred.
iStent can effectively control intraocular pressure in mild glaucoma, reducing medication reliance and improving patient quality of life.
描述iStent植入术作为早期未控制青光眼的独立手术的结果，随访结果长达24个月。
一项回顾性单中心病例系列研究，纳入了开角型青光眼（OAG）患者、眼压未得到控制（定义为眼压≥18 mmHg）且正在使用1 - 4种青光眼药物的患者，将iStent作为独立手术进行植入。排除标准为iStent植入的禁忌证。主要观察指标为与基线相比，6个月、12个月、18个月和24个月时的眼压，以及基线和24个月时的药物使用数量。
纳入了88例患者的88只眼，年龄为57.6±9.8岁。10只眼在随访期间接受了后续青光眼手术，被排除在分析之外。平均眼压（mmHg）从基线时的20.54±1.42分别降至12个月和24个月随访时的15.99±1.98和16.15±2.21（n = 78，p < 0.001），24个月时平均药物使用数量从2.35±0.70降至1.31±0.80（p < 0.001）。在这些眼中，59%在24个月时眼压降低≥20%，91%在24个月时眼压≤18 mmHg，71.8%使用的药物减少。在24个月时，14.1%的眼无需使用药物，而基线时无此情况。未发生严重的术中或术后不良事件。
iStent可有效控制轻度青光眼的眼压，减少对药物的依赖并改善患者生活质量。
