Abstract：
OBJECTIVE: 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.
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).
CONCLUSIONS: The results of this study suggest that the iStent inject W® technique constitutes an effective and safe option for tension control and glaucoma treatment.
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).
CONCLUSIONS: The results of this study suggest that the iStent inject W® technique constitutes an effective and safe option for tension control and glaucoma treatment.
摘要：
目的：为了评估疗效，安全,在三级医院的开角型青光眼或高眼压患者中插入iStentinject®植入物后的结构和功能进展。
方法：一项回顾性研究包括98眼（男57眼，女41眼）患有开角型青光眼或高眼压，进行了iStent注射W®植入(Glaukos，Corporation,CA）在2018年12月至2022年12月之间。眼内压（IOP）的差异，使用的低血压眼药水的数量，结构和功能测试在术前值和随后的审查之间进行了评估在随访期间的一个（n=98），两个（n=55），术后3年（n=15）。
结果：在研究的98只眼睛中，85％被诊断为开角型青光眼（50％轻度，32%中等,18％严重）和15％的高眼压。除了1个月（p=0.36）和3年（p=0.39）的访视外，所有访视的IOP与术前值相比均有统计学上的显着降低。视力从0.39±0.25提高到0.72±0.24(p<0.01),考虑到很大一部分干预措施包括白内障手术。手术前,66%的样本使用了2种或更多的降压药物。手术后,降血压药物的数量减少（3年时从1.88±0.84降至0.21±0.59）（p<0.01），在三年内药物数量减少了88.9%。手术后,75%的患者不需要任何药物治疗。关于结构和功能测试，视网膜神经纤维层厚度（RNFL（p=0.35），开挖/乳头比E/P（p=0.31），视功能指数(VFI(p=0.06)，和偏差平均值（MD（p=0.06）显示干预后无统计学差异。然而,模式的标准偏差(DSM)确实表现出差异，从5.46±4.03dB下降到5.34±3.48dB（p=0.02）。
结论：这项研究的结果表明，iStent注射W®技术是张力控制和青光眼治疗的有效且安全的选择。
方法：一项回顾性研究包括98眼（男57眼，女41眼）患有开角型青光眼或高眼压，进行了iStent注射W®植入(Glaukos，Corporation,CA）在2018年12月至2022年12月之间。眼内压（IOP）的差异，使用的低血压眼药水的数量，结构和功能测试在术前值和随后的审查之间进行了评估在随访期间的一个（n=98），两个（n=55），术后3年（n=15）。
结果：在研究的98只眼睛中，85％被诊断为开角型青光眼（50％轻度，32%中等,18％严重）和15％的高眼压。除了1个月（p=0.36）和3年（p=0.39）的访视外，所有访视的IOP与术前值相比均有统计学上的显着降低。视力从0.39±0.25提高到0.72±0.24(p<0.01),考虑到很大一部分干预措施包括白内障手术。手术前,66%的样本使用了2种或更多的降压药物。手术后,降血压药物的数量减少（3年时从1.88±0.84降至0.21±0.59）（p<0.01），在三年内药物数量减少了88.9%。手术后,75%的患者不需要任何药物治疗。关于结构和功能测试，视网膜神经纤维层厚度（RNFL（p=0.35），开挖/乳头比E/P（p=0.31），视功能指数(VFI(p=0.06)，和偏差平均值（MD（p=0.06）显示干预后无统计学差异。然而,模式的标准偏差(DSM)确实表现出差异，从5.46±4.03dB下降到5.34±3.48dB（p=0.02）。
结论：这项研究的结果表明，iStent注射W®技术是张力控制和青光眼治疗的有效且安全的选择。
