丝裂霉素C小梁切除术与开放结膜外放置45 μm明胶支架的效果比较。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma Pub Date : 2024-05-01 DOI:10.1016/j.ogla.2023.11.005

Ernesto Sabogal BS, BA, Zoë Ingram BS, Nino Odishelidze MD, Hani El Helwe MD, Henisk K. Falah BS, Jonathan Trzcinski BS, Nathan Hall MS, David Solá-Del Valle MD

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引用次数: 0

摘要

目的:比较青光眼患者小梁切除术与丝裂霉素C (trab-MMC)和XEN®45凝胶支架(XGS AEO)联合或不联合白内障手术。设计:非随机、回顾性比较研究。受试者:在2018年7月至2021年8月期间，来自204名青光眼患者的204只眼睛，这些患者接受了XGS放置AEO或接受了trab-MMC伴或不伴白内障手术。方法:回顾某三级分诊中心2018-2021年204例患者在trab-MMC或XGS AEO后的就诊情况。主要结局指标:眼压(IOP)、用药负担、Kaplan-Meier成功率、5-氟尿嘧啶影响和并发症。结果:trab-MMC 157例，XGS AEO 47例。各组有相似的基线眼压(IOP)和药物(药物)。IOP和药物在1.5年时也有相似的下降(11.2 mmHg vs 7.4 mmHg, p=0.62;trab-MMC和XGS AEO分别为2.9 vs 2.8, p=0.92)。成功定义为IOP降低≥20%，5 mmHg≤IOP≤18 mmHg连续2次就诊。完全成功(CS)不允许用药;≤基线用药的合格成功率(QS)。当前60天的IOP波动不被计算为失败时，trb - mmc的CS为43%，比XGS AEO高约8.5%(结论:XGS AEO可能提供与trb - mmc相似的益处，特别是对于耐受某些药物的患者，手术时间更短。

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Comparing Outcomes of Trabeculotomy with Mitomycin C to 45-μm Gelatin Stent Placed Ab Externo with Open Conjunctiva

Purpose

To compare trabeculectomy with mitomycin C (trab-MMC) and XEN45 Gel Stent placed ab externo with open conjunctiva (XGS AEO) with or without cataract surgery in patients with glaucoma.

Design

Nonrandomized, retrospective, comparative study.

Subjects

A total of 204 eyes from 204 glaucoma patients who received XGS AEO or underwent trab-MMC with or without cataract surgery between July 2018 and August 2021 at Massachusetts Eye and Ear.

Methods

Visits from 204 patient charts were reviewed after either trab-MMC or XGS AEO from 2018 to 2021 from a level 3 triage center.

Main Outcome Measures

Intraocular pressure (IOP), medication burden, Kaplan–Meier success rates, 5-fluorouracil impact, and complications.

Results

One hundred fifty-seven patients underwent trab-MMC and 47 underwent XGS AEO. Groups had similar baseline intraocular pressure (IOP) and medications (meds). Intraocular pressure and meds decreased similarly at 1.5 years (11.2 mmHg vs. 7.4 mmHg, P = 0.62; 2.9 vs. 2.8 meds, P = 0.92, respectively for trab-MMC and XGS AEO). Success was defined as IOP reduction ≥ 20% with 5 mmHg ≤ IOP ≤ 18 mmHg for 2 consecutive visits. Complete success (CS) did not allow meds; qualified success (QS) allowed for ≤ baseline meds. When IOP fluctuations in the first 60 days were not counted as failures, CS was 43% for trab-MMC, about 8.5% higher than for XGS AEO (P < 0.01). Qualified success was similar between the groups (65%–67%). Procedure time was shorter for XGS AEO than trab-MMC (44 vs. 63 minutes, P < 0.01).