结论:在杜克眼科中心接受比马前列素植入的青光眼患者的回顾性研究中,植入后12个月,局部用降低眼压药物的数量显著减少.
目的:在临床实践中,研究比马前列素植入物对青光眼患者眼内压(IOP)的影响以及对局部降眼压药物的需求。
方法:确定了2020年11月至2021年10月在杜克大学眼科中心接受比马前列素植入的患者。排除标准包括与植入物同时添加其他降低IOP的药物和<1个月的随访。计算植入物后从基线到第1、3、6、9和12个月的IOP变化和局部降低IOP的药物数量。对不同严重程度的青光眼进行亚组分析。
结果:共纳入63例患者和92只眼(平均年龄77.8±10.1岁)。青光眼严重程度从轻度(11%),中等(30%),严重(54%)。所有时间点的IOP均无显著下降。在第1、3、6、9和12个月,局部降眼压药物的平均数量分别显着减少了0.81、0.75、0.63、0.70和0.67(均P<0.001)。药物总数没有显著变化,包括比马前列素植入物.当除以青光眼严重程度时,轻度/中度疾病在1个月,3个月和6个月时局部用药数量显著减少,重度疾病在1个月时局部用药数量显著减少.在后续期间,19只眼睛接受了额外的激光或外科手术,其中68%有切口性青光眼手术史。
结论:比马前列素植入物可在1年内减少局部降眼压药物的需要,尤其是轻度至中度青光眼。在严重的青光眼中,植入物的功效可能更有限,需要进一步的工作来表征其长期影响。
CONCLUSIONS: In this retrospective study of glaucoma patients receiving the
bimatoprost implant at Duke Eye Center, the number of topical intraocular pressure-lowering medications was significantly reduced through 12 months after the implant.
OBJECTIVE: To study the effects of the
bimatoprost implant on intraocular pressure (IOP) and the need for topical IOP-lowering medications in glaucoma patients in the clinical practice setting.
METHODS: Patients who received the
bimatoprost implant at Duke Eye Center from November 2020 to October 2021 were identified. Exclusion criteria included addition of other IOP-lowering medications concurrent with the implant and <1 month of follow-up. The change in IOP and number of topical IOP-lowering medications from baseline to months 1, 3, 6, 9, and 12 after the implant was calculated. Subgroup analysis was performed for different glaucoma severities.
RESULTS: A total of 63 patients and 92 eyes were included (mean age 77.8 ± 10.1 years). Glaucoma severity ranged from mild (11%), moderate (30%), to severe (54%). There was a nonsignificant decrease in IOP at all timepoints. The mean number of topical IOP-lowering medications significantly decreased by 0.81, 0.75, 0.63, 0.70, and 0.67 at month 1, 3, 6, 9, and 12, respectively (all P < 0.001). There was no significant change in the total number of medications, including the
bimatoprost implant. When divided by glaucoma severity, the reduction in the number of topical medications was significant at 1, 3, and 6 months for mild/moderate disease and at 1 month for severe disease. During the follow-up period, 19 eyes underwent additional laser or surgical procedures, 68% of which had a history of prior incisional glaucoma surgery.
CONCLUSIONS: The
bimatoprost implant may reduce the need for topical IOP-lowering agents over a 1-year period, especially in mild to moderate-stage glaucoma. The efficacy of the implant may be more limited in severe glaucoma, and further work is needed to characterize its long-term effects.