目的:比较小梁切除术与丝裂霉素C(trab-MMC)和XEN®45凝胶支架放置在开放结膜(XGSAEO)外,伴或不伴白内障手术的青光眼患者。
方法:非随机,回顾性比较研究。
方法:在2018年7月至2021年8月期间,来自204例接受XGS的青光眼患者的204只眼在马萨诸塞州眼和耳部接受AEO或接受了有或没有白内障手术的trab-MMC。
方法:根据trab-MMC或XGSAEO从2018年至2021年从3级分诊中心对204例患者的就诊进行了回顾。
方法:眼内压(IOP),药物负担,Kaplan-Meier成功率,5-氟尿嘧啶的影响,和并发症。
结果:157例患者接受了trab-MMC,47例接受了XGSAEO。各组具有相似的基线眼内压(IOP)和药物(药物)。眼压和药物在1.5年时类似地下降(11.2mmHg对7.4mmHg,p=0.62;2.9对2.8药物,p=0.92,分别为trab-MMC和XGSAEO)。成功定义为连续2次就诊的IOP降低≥20%,5mmHg≤IOP≤18mmHg。完全成功(CS)不允许用药;合格成功(QS)允许≤基线药物。当前60天的IOP波动不计入故障时,trab-MMC的CS为43%,比XGSAEO高约8.5%(p<0.01)。两组之间的QS相似(65-67%)。XGSAEO的手术时间短于trab-MMC(44vs63分钟,p<0.01)。
结论:XGSAEO可能提供与trab-MMC类似的益处,尤其是对一些药物耐受的病人,更短的程序时间。
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.
Nonrandomized, retrospective, comparative study.
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.
Visits from 204 patient charts were reviewed after either trab-MMC or XGS AEO from 2018 to 2021 from a level 3 triage center.
Intraocular pressure (IOP), medication burden, Kaplan-Meier success rates, 5-fluorouracil impact, and complications.
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).
XEN45 Gel Stent AEO may provide similar benefits to trab-MMC, especially for patients who tolerate some meds, with shorter procedure times.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.