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
{"title":"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。","authors":"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","doi":"10.1016/j.ogla.2023.11.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>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.</p></div><div><h3>Design</h3><p>Nonrandomized, retrospective, comparative study.</p></div><div><h3>Subjects</h3><p>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.</p></div><div><h3>Methods</h3><p>Visits from 204 patient charts were reviewed after either trab-MMC or XGS AEO from 2018 to 2021 from a level 3 triage center.</p></div><div><h3>Main Outcome Measures</h3><p>Intraocular pressure (IOP), medication burden, Kaplan–Meier success rates, 5-fluorouracil impact, and complications.</p></div><div><h3>Results</h3><p>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, <em>P</em> = 0.62; 2.9 vs. 2.8 meds, <em>P</em> = 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 (<em>P</em> < 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, <em>P</em> < 0.01).</p></div><div><h3>Conclusions</h3><p>XEN45 Gel Stent AEO may provide similar benefits to trab-MMC, especially for patients who tolerate some meds, with shorter procedure times.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589419623002107/pdfft?md5=e3c17f9c1144db37f437f7d12d615f62&pid=1-s2.0-S2589419623002107-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Comparing Outcomes of Trabeculotomy with Mitomycin C to 45-μm Gelatin Stent Placed Ab Externo with Open Conjunctiva\",\"authors\":\"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\",\"doi\":\"10.1016/j.ogla.2023.11.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>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.</p></div><div><h3>Design</h3><p>Nonrandomized, retrospective, comparative study.</p></div><div><h3>Subjects</h3><p>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.</p></div><div><h3>Methods</h3><p>Visits from 204 patient charts were reviewed after either trab-MMC or XGS AEO from 2018 to 2021 from a level 3 triage center.</p></div><div><h3>Main Outcome Measures</h3><p>Intraocular pressure (IOP), medication burden, Kaplan–Meier success rates, 5-fluorouracil impact, and complications.</p></div><div><h3>Results</h3><p>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, <em>P</em> = 0.62; 2.9 vs. 2.8 meds, <em>P</em> = 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 (<em>P</em> < 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, <em>P</em> < 0.01).</p></div><div><h3>Conclusions</h3><p>XEN45 Gel Stent AEO may provide similar benefits to trab-MMC, especially for patients who tolerate some meds, with shorter procedure times.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>\",\"PeriodicalId\":19519,\"journal\":{\"name\":\"Ophthalmology. Glaucoma\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2589419623002107/pdfft?md5=e3c17f9c1144db37f437f7d12d615f62&pid=1-s2.0-S2589419623002107-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmology. 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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.
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).
Conclusions
XEN45 Gel Stent AEO may provide similar benefits to trab-MMC, especially for patients who tolerate some meds, with shorter procedure times.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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