Vander Zee Brandon L, Wilson Caroline, Berdahl John P, Terveen Daniel, Ferguson Tanner J
Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Nebraska, United States.
Department of Ophthalmology, Hiawatha Eye Clinic, Hiawatha, Iowa, United States.
J Curr Glaucoma Pract. 2024 Apr-Jun;18(2):63-67. doi: 10.5005/jp-journals-10078-1441. Epub 2024 Jul 10.
To compare the safety and efficacy of subconjunctival gel stent implantation in the superonasal (SN) vs inferonasal (IN) quadrants in the treatment of glaucoma.
Patients with a history of IN ( = 29) or SN, ( = 96) gel stent placement with ≥3 months of follow-up were included. Intraocular pressure (IOP) and the number of glaucoma medications were collected preoperatively and postoperatively at months 1, 3, 6, and 12. Safety measures included the number of bleb needlings, complication rate, and additional surgeries.
Mean baseline IOP was 32.4 ± 11.7 mm Hg in the IN group and 21.6 ± 9.2 mm Hg in the SN group ( < 0.01). IOP was similar between groups at 3 months (IN = 15.8, SN = 15.6, = 0.45), 6 months (IN = 17.4, SN = 15, = 0.13), and 12 months (IN = 17.9, SN = 14.7, = 0.15) follow-up. The number of glaucoma medications was also similar at 3 months ( = 0.31), 6 months ( = 0.24), and 12 months ( = 0.39) follow-up. Bleb needling rates were similar with 51.7% (15/29) in the IN group vs 42.7% (41/96) in the SN group ( = 0.39) and subjects requiring further surgery were 17.2% (5/29) in the IN group vs 24.0% (23/96) in the SN group ( = 0.45).
Both IN and SN subconjunctival gel stent placements provide favorable safety and efficacy when treating open-angle glaucoma, with a meaningful decrease in medication use and IOP.
Implantation of the subconjunctival gel stent in the IN quadrant is an effective and safe alternative to superior implantation in refractory glaucoma.
Vander Zee BL, Wilson C, Berdahl JP, Superonasal vs Inferonasal Subconjunctival Gel Stent Placement in Patients with Glaucoma. J Curr Glaucoma Pract 2024;18(2):63-67.
比较鼻上象限（SN）与鼻下象限（IN）结膜下凝胶支架植入术治疗青光眼的安全性和有效性。
纳入有鼻下象限（n = 29）或鼻上象限（n = 96）凝胶支架植入史且随访时间≥3个月的患者。收集术前及术后1、3、6和12个月时的眼压（IOP）及青光眼药物使用数量。安全指标包括滤泡针刺次数、并发症发生率及额外手术情况。
鼻下象限组平均基线眼压为32.4±11.7 mmHg，鼻上象限组为21.6±9.2 mmHg（P < 0.01）。随访3个月时两组眼压相似（鼻下象限组 = 15.8，鼻上象限组 = 15.6，P = 0.45），6个月时（鼻下象限组 = 17.4，鼻上象限组 = 15，P = 0.13）及12个月时（鼻下象限组 = 17.9，鼻上象限组 = 14.7，P = 0.15）也相似。随访3个月（P = 0.31）、6个月（P = 0.24）及12个月（P = 0.39）时青光眼药物使用数量也相似。滤泡针刺率相似，鼻下象限组为51.7%（15/29），鼻上象限组为42.7%（41/96）（P = 0.39），需要进一步手术的患者在鼻下象限组为17.2%（5/29），鼻上象限组为24.0%（23/96）（P = 0.45）。
鼻下象限和鼻上象限结膜下凝胶支架植入术在治疗开角型青光眼时均具有良好的安全性和有效性，药物使用及眼压均有显著降低。
在难治性青光眼患者中，鼻下象限结膜下凝胶支架植入术是上方植入术的一种有效且安全的替代方法。
Vander Zee BL, Wilson C, Berdahl JP, 青光眼患者鼻上象限与鼻下象限结膜下凝胶支架植入术。《当代青光眼实践杂志》2024;18(2):63 - 67。
