Análisis a tres años de resultados, seguridad y progresión en pacientes con glaucoma de ángulo abierto o hipertensión ocular, intervenidos de microcirugía trabecular

Q3 Medicine Archivos De La Sociedad Espanola De Oftalmologia Pub Date : 2024-11-01 DOI:10.1016/j.oftal.2024.06.002

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.

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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。

材料和方法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例开角型青光眼或眼压过高患者（57例男性，41例女性）。在术后一年（98 例）、两年（55 例）和三年（15 例）的随访期间，对术前值与后续复查值之间的眼压（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。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。考虑到相当一部分干预措施包括白内障手术，视力从 0.39 ± 0.25 提高到 0.72 ± 0.24（p< 0.01）。手术前，66% 的样本使用了 2 种或 2 种以上降压药物。手术后，降压药物的数量有所减少（从 1.88 ± 0.84 降至 3 年后的 0.21 ± 0.59）（p< 0.01），三年内药物数量减少了 88.9%。在结构和功能测试方面，视网膜神经纤维层厚度（RNFL）（p = 0.35）、挖空/乳头比率 E/P（p = 0.31）、视功能指数（VFI）（p = 0.06）和平均偏差（MD）（p = 0.06）在干预后无显著统计学差异。结论本研究结果表明，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 Medicine-Ophthalmology

CiteScore

1.20

自引率

0.00%

发文量

109

审稿时长

78 days

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.