PDF(Pubmed)
Abstract：
Objectives: To investigate whether phakia affects the outcome of XEN-45 gel stent implantation in the treatment of pseudoexfoliative glaucoma (PXG). Methods: A retrospective, comparative cohort study of 30 phakic and 55 pseudophakic PXG patients who received the XEN-45 gel stent at a tertiary centre. The primary outcome measure was two-year success defined as a ≥20% lowering of intraocular pressure (IOP) and a target IOP of 6-21 mmHg. Success was complete without and qualified irrespective of antiglaucoma medication use. Further glaucoma surgery other than needling was regarded as a failure. The secondary outcome measures included changes in IOP, revision and complication rates. Results: The complete two-year success rates were 70% and 59% in the phakic and pseudophakic groups, respectively (p = 0.75, log-rank test), and the qualified rates were 80% and 72%, respectively (p = 0.89). The median IOP reduction from baseline was 54% in phakic, and 46% in pseudophakic eyes. While needling rates were similar, the incidence of early incisional bleb revisions was significantly higher in the phakic eyes (13% vs. 0% within 3 months; p = 0.0098, chi-square). Increasing after a year, significantly more pseudophakic eyes failed due to secondary glaucoma surgery (16% vs. 0%; p = 0.0191). Conclusions: The XEN-45 gel stent offers equally effective IOP control for both phakic and pseudophakic patients. However, the onset of bleb revisions and the necessity for secondary glaucoma surgery differed significantly between the groups.
摘要：
目的:探讨假性剥脱性青光眼(PXG)的治疗效果是否对XEN-45凝胶支架植入术的影响。方法：回顾性分析，在三级中心接受XEN-45凝胶支架的30例PXG患者和55例假晶状体患者的比较队列研究。主要结果指标是两年成功率，定义为眼内压（IOP）降低≥20％，目标IOP为6-21mmHg。无论是否使用抗青光眼药物，成功都是完整且合格的。除针刺以外的其他青光眼手术被认为是失败的。次要结果指标包括眼压变化，翻修率和并发症发生率。结果:有晶状体组和假晶状体组的两年完全成功率分别为70%和59%,分别(p=0.75，对数秩检验)，合格率分别为80%和72%，分别(p=0.89)。眼压从基线降低的中位数为54%，假晶状体眼占46%。虽然针刺率相似，有晶状体眼的早期切口出血翻修的发生率明显较高(13%vs.3个月内为0%；p=0.0098，卡方）。一年后增加，明显更多的假晶状体眼由于继发性青光眼手术而失败(16%vs.0%；p=0.0191）。结论：XEN-45凝胶支架为有晶状体和假晶状体患者提供同样有效的IOP控制。然而,两组间气泡修正的开始和继发性青光眼手术的必要性存在显著差异.
