Three-year analysis of results, safety and progression in patients with open-angle glaucoma or ocular hypertension, undertaking trabecular microsurgery

Archivos de la Sociedad Espanola de Oftalmologia Pub Date : 2024-11-01 DOI:10.1016/j.oftale.2024.07.005

M. Parrilla Vallejo , J.A. Aguiar Caro , M. Girón Ortega , C.J. Cortés Laborda , M.J. Cano Gómez , P. Molina Solana , E. Rodríguez de la Rúa Franch

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Abstract

Aim

To evaluate the efficacy, safety, structural and functional progression following the insertion of iStent inject ® implants in patients with open-angle glaucoma or ocular hypertension at a tertiary-level hospital.

Materials and methods

A retrospective study included 98 eyes (57 males and 41 females) with open-angle glaucoma or ocular hypertension, which underwent iStent inject W® implantation (Glaukos, Corporation, CA) between December 2018 and December 2022. Differences in intraocular pressure (IOP), the number of hypotensive eye drops used, and structural and functional tests were assessed between preoperative values and subsequent reviews during a follow-up period of one (n = 98), two (n = 55), and three years (n = 15) after surgery.

Results

Among the 98 eyes studied, 85% were diagnosed with open-angle glaucoma (50% mild, 32% moderate, and 18% severe) and 15% with ocular hypertension. There was a statistically significant reduction in IOP compared to preoperative values for all visits except the 1-month (p = 0.36) and 3-year (p = 0.39) visits. Visual acuity increased from 0.39 ± 0.25 to 0.72 ± 0.24 (p < 0.01), considering that a significant portion of the interventions included cataract surgery. Before surgery, 66% of the sample used 2 or more hypotensive medications. Post-surgery, the number of hypotensive medications decreased (from 1.88 ± 0.84 to 0.21 ± 0.59 at 3 years) (p < 0.01), with an 88.9% reduction in the number of medications over three years. After surgery, 75% of cases did not require any medication.

Regarding structural and functional tests, thickness of retinal nerve fiber layers (RNFL (p = 0.35), excavation / papilla ratio E/P (p = 0.31), visual function index

(VFI (p = 0.06), and deviation mean (MD (p = 0.06) showed no statistically significant differences post-intervention. However, standard deviation of the pattern (DSM) did exhibit differences, decreasing from 5.46 ± 4.03 dB to 5.34 ± 3.48 dB (p = 0.02).

Conclusion

The results of this study suggest that the iStent inject W® technique constitutes an effective and safe option for tension control and glaucoma treatment.

查看原文本刊更多论文

对接受小梁显微手术的开角型青光眼或眼压过高患者的治疗效果、安全性和进展情况进行为期三年的分析。

目的：评估一家三级医院对开角型青光眼或眼压过高患者植入iStent inject ®植入物后的疗效、安全性、结构和功能进展：一项回顾性研究纳入了2018年12月至2022年12月期间接受iStent inject W®植入术（Glaukos公司，加利福尼亚州）的98只开角型青光眼或眼压过高的眼睛（57只男性，41只女性）。在术后一年（n = 98）、两年（n = 55）和三年（n = 15）的随访期间，对术前值与后续复查之间的眼压（IOP）差异、降压眼药水使用次数以及结构和功能测试进行了评估：在接受研究的 98 只眼睛中，85% 被诊断为开角型青光眼（50% 轻度、32% 中度和 18% 重度），15% 被诊断为眼压过高。与术前值相比，除1个月（p = 0.36）和3年（p = 0.39）检查外，所有检查的眼压均有统计学意义上的显著降低。视力从 0.39 ± 0.25 提高到 0.72 ± 0.24（p 结论：该研究结果表明，眼压降低与眼压升高有关：本研究结果表明，iStent inject W® 技术是控制眼压和治疗青光眼的有效而安全的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archivos de la Sociedad Espanola de Oftalmologia

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