Long‑term outcomes of two first‑generation trabecular micro‑bypass stents(iStent)with phacoemulsification in primary open‑angle glaucoma:eight‑year results  

作　　者：Ali Salimi Harrison Watt Paul Harasymowycz 

机构地区：[1]Department of Ophthalmology,Faculty of Medicine,McGill University,Montreal,QC,Canada [2]Montreal Glaucoma Institute,Montreal,QC,Canada [3]Faculty of Medicine,McGill University,Montreal,QC,Canada [4]Department of Ophthalmology,University of Montreal,4135 de Rouen,Montreal,QC H1V1G5,Canada

出　　处：《Eye and Vision》2021年第1期431-442,共12页眼视光学杂志（英文）

摘　　要：Background:The short-and medium-term outcomes of iStent have been extensively studied;however,only few studies have investigated its long-term outcomes.Here,we assessed the long-term efficacy and safety of two iStents with concomitant cataract surgery in glaucomatous eyes while also evaluating measures of disease stability using visual field and optical coherence tomography(OCT)of the optic nerve and the macula throughout 8 years of follow-up.Methods:This longitudinal,single-center consecutive case series included glaucomatous eyes that underwent implantation of two first-generation trabecular micro-bypass stents(iStent)with concomitant cataract surgery.Eight-year efficacy outcomes included mean intraocular pressure(IOP)and medications,as well as surgical success.Eight-year safety outcomes included best-corrected visual acuity(BCVA),visual field mean deviation(VF-MD),cup-todisc ratio(CDR),retinal nerve fiber layer(RNFL)thickness,ganglion cell-inner plexiform layer(GC-IPL)thickness,and adverse events.Results:A total of 62 eyes with primary open-angle glaucoma(POAG)were included.At 8 years postoperative,IOP reduced by 26%from 19.2±3.9 mmHg preoperatively to 14.2±2.4 mmHg(P<0.001),91.1%of eyes achieved IOP≤18 mmHg(vs.51.6%preoperatively),69.6%of eyes achieved IOP≤15 mmHg(vs.14.5%preoperatively),and 25%of eyes achieved IOP≤12 mmHg(vs.1.6%preoperatively).Medication use decreased by 17.9%from 2.8±1.1 preoperatively to 2.3±1.2(P=0.018).Surgical success was 90%,as six eyes underwent subsequent glaucoma surgeries.Safety measures of BCVA,CDR,RNFL thickness and GC-IPL thickness remained stable through 8 years postoperative.VF-MD remained stable until postoperative year 5 and subsequently progressed according to the natural history of glaucomatous disease.Conclusions:Implantation of two iStents with concomitant cataract surgery is an effective and safe treatment option for surgery-naïve POAG eyes,evidenced by significant IOP and medication reductions,reasonable surgical success,and favorable safety outcomes,throug

关 键 词：Minimally invasive glaucoma surgery MIGS Trabecular micro-bypass stent iStent GLAUCOMA Cataract surgery Long-term outcomes 

分 类 号：R779.6[医药卫生—眼科]