Charytonowicz Anna, Błażowski Jakub, Konopińska Joanna
Department of Ophthalmology, Medical University of Bialystok, 15-276 Bialystok, Poland.
J Clin Med. 2025 Aug 18;14(16):5819. doi: 10.3390/jcm14165819.
: Glaucoma refers to a group of eye diseases that damage the optic nerve, causing irreversible vision loss. It typically begins with peripheral vision impairment and, in severe cases, leads to complete blindness. A major advancement in glaucoma treatment is Microinvasive Glaucoma Surgery (MIGS), including trabecular bypass and ab interno trabeculectomy, which are generally used for mild to moderate glaucoma. This review aimed to evaluate the efficacy and safety of iStent micro-bypass implantation and Kahook Dual Blade (KDB) goniotomy combined with phacoemulsification in patients with open-angle glaucoma (OAG). : A review of recent studies was conducted using PubMed, Google Scholar, Scopus, Web of Science, and Embase. Both prospective and retrospective clinical studies were included. These MIGS methods were compared for reducing intraocular pressure (IOP) and medication burden at baseline and endpoint. : Eleven studies involving 1925 eyes were analyzed. All studies showed that iStent (first- and second-generation) micro-bypass implantation and KDB goniotomy reduced IOP, favoring the phaco-KDB group. Antiglaucoma medication use also decreased significantly. The success rate was sufficient and most complications were minimal. : In conclusion, iStent implantation and KDB goniotomy offer a high safety profile, meaningful IOP reduction, a minimally invasive approach, and quick recovery.
青光眼是指一组损害视神经、导致不可逆视力丧失的眼部疾病。它通常始于周边视力受损，严重时会导致完全失明。青光眼治疗的一项重大进展是微创青光眼手术（MIGS），包括小梁旁路手术和内路小梁切除术，这些手术通常用于轻度至中度青光眼。本综述旨在评估iStent微旁路植入术和Kahook双刃刀（KDB）房角切开术联合超声乳化术治疗开角型青光眼（OAG）患者的疗效和安全性。：使用PubMed、谷歌学术、Scopus、科学网和Embase对近期研究进行了综述。纳入了前瞻性和回顾性临床研究。比较了这些MIGS方法在基线和终点时降低眼压（IOP）和药物负担的情况。：分析了11项涉及1925只眼的研究。所有研究均表明，iStent（第一代和第二代）微旁路植入术和KDB房角切开术可降低眼压，phaco-KDB组更具优势。抗青光眼药物的使用也显著减少。成功率足够，大多数并发症轻微。：总之，iStent植入术和KDB房角切开术具有高安全性、显著降低眼压、微创方法和快速恢复的特点。
