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开角型青光眼患者中第二代小梁微旁路支架的真实世界评估

Real-world assessment of second-generation trabecular micro-bypass stents in open-angle glaucoma patients.

作者信息

Vohra Vishal, Madgula Indira, Chawla Harshika

机构信息

Department of Ophthalmology, Royal Preston Hospital, Preston, United Kingdom.

Department of Ophthalmology, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom.

出版信息

Adv Ophthalmol Pract Res. 2024 Oct 18;5(1):16-21. doi: 10.1016/j.aopr.2024.09.002. eCollection 2025 Feb-Mar.

Abstract

BACKGROUND

To assess the safety and efficacy of iStent inject placement in individuals with glaucoma with open angles in real world clinical settings.

METHODS

A review was conducted on the medical records of individuals who received iStent inject implants starting from March 2018. The analysis focused on reductions in intraocular pressure (IOP) and glaucoma medication usage. Safety assessments encompassed intraoperative and postoperative issues, additional surgeries, and improvements in best-corrected visual acuity (BCVA).

RESULTS

Analysis of 55 eyes of 48 patients that underwent iStent implantation revealed a mean age of 77 years (range: 51-97). The initial average intraocular pressure (IOP) in these eyes was 20.2 ​± ​6.4 ​mm Hg. Following surgery, IOP decreased by ​≥ ​20% compared to preoperative levels in 21 eyes (43.8%) over the 12-month follow-up period. Notably, there was a significant reduction in medication usage by the 12-month mark ( ​< ​0.0042). Among the evaluated eyes, 9 exhibited a response to steroids, 3 had stents that were improperly positioned, 5 had stents that were over implanted, and 1 eye experienced an episode of iris prolapse.

CONCLUSIONS

The findings from the 12-month follow-up of iStent inject implants in standard clinical settings demonstrate a notable decrease in both intraocular pressure (IOP) and medication usage in eyes with concurrent open-angle glaucoma.

摘要

背景

评估在现实世界临床环境中,iStent inject植入术在开角型青光眼患者中的安全性和有效性。

方法

对2018年3月起接受iStent inject植入术的患者的病历进行回顾。分析重点在于眼压(IOP)降低情况和青光眼药物使用情况。安全性评估包括术中及术后问题、额外手术以及最佳矫正视力(BCVA)的改善情况。

结果

对48例接受iStent植入术的患者的55只眼睛进行分析,患者平均年龄为77岁(范围:51 - 97岁)。这些眼睛的初始平均眼压(IOP)为20.2 ± 6.4 mmHg。术后,在12个月的随访期内,21只眼睛(43.8%)的眼压较术前水平降低了≥20%。值得注意的是,到12个月时药物使用量显著减少(<0.0042)。在评估的眼睛中,9只对类固醇有反应,3只支架位置不当,5只支架植入过多,1只眼睛发生虹膜脱垂。

结论

在标准临床环境中对iStent inject植入术进行12个月随访的结果表明,伴有开角型青光眼的眼睛的眼压(IOP)和药物使用量均显著降低。

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