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
{"title":"对接受小梁显微手术的开角型青光眼或眼压过高患者的疗效、安全性和病情进展进行为期三年的分析。","authors":"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","doi":"10.1016/j.oftal.2024.06.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div><div>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</div><div>(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).</div></div><div><h3>Conclusion</h3><div>The results of this study suggest that the iStent inject W® technique constitutes an effective and safe option for tension control and glaucoma treatment.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"99 11","pages":"Pages 485-492"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Análisis a tres años de resultados, seguridad y progresión en pacientes con glaucoma de ángulo abierto o hipertensión ocular, intervenidos de microcirugía trabecular\",\"authors\":\"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\",\"doi\":\"10.1016/j.oftal.2024.06.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aim</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div><div>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</div><div>(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).</div></div><div><h3>Conclusion</h3><div>The results of this study suggest that the iStent inject W® technique constitutes an effective and safe option for tension control and glaucoma treatment.</div></div>\",\"PeriodicalId\":8348,\"journal\":{\"name\":\"Archivos De La Sociedad Espanola De Oftalmologia\",\"volume\":\"99 11\",\"pages\":\"Pages 485-492\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archivos De La Sociedad Espanola De Oftalmologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0365669124001163\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archivos De La Sociedad Espanola De Oftalmologia","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0365669124001163","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Análisis a tres años de resultados, seguridad y progresión en pacientes con glaucoma de ángulo abierto o hipertensión ocular, intervenidos de microcirugía trabecular
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.
期刊介绍:
La revista Archivos de la Sociedad Española de Oftalmología, editada mensualmente por la propia Sociedad, tiene como objetivo publicar trabajos de investigación básica y clínica como artículos originales; casos clínicos, innovaciones técnicas y correlaciones clinicopatológicas en forma de comunicaciones cortas; editoriales; revisiones; cartas al editor; comentarios de libros; información de eventos; noticias personales y anuncios comerciales, así como trabajos de temas históricos y motivos inconográficos relacionados con la Oftalmología. El título abreviado es Arch Soc Esp Oftalmol, y debe ser utilizado en bibliografías, notas a pie de página y referencias bibliográficas.