Three-year canaloplasty outcomes for the treatment of open-angle glaucoma: European study results
Three-year canaloplasty outcomes for the treatment of open-angle glaucoma: European study results
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DOI：
10.1007/s00417-011-1728-3
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发表时间：
2011-10-01
影响因子：
2.7
通讯作者：
Tetz, Manfred
中科院分区：
文献类型：
--
作者：
Bull, Holger;von Wolff, Kurt;Tetz, Manfred
报告3年的研究结果，研究管成形术的安全性和有效性，这是一种涉及施勒姆管的周向粘扩张和内管壁张紧的手术，用于治疗开角型青光眼。本研究是一项前瞻性、多中心、介入性研究，对109例成人开角青光眼患者的109只眼进行了白内障管成形术或白内障管成形术联合手术。术前符合条件的眼压（IOP）至少为16 mmHg，既往眼压至少为21 mmHg，无论是否接受药物治疗。一个柔性微导管被用来粘扩管的整个周长，并放置小梁张力缝合线。主要结局指标包括IOP、青光眼药物使用和不良事件。行小管成形术的眼睛平均基线IOP为23.0 +/- 4.3 mmHg，平均青光眼药物使用1.9 +/- 0.7种药物，术后3年平均IOP降至15.1 +/- 3.1 mmHg，使用0.9 +/- 0.9种药物。联合白内障-小管成形术的眼睛在1.5 +/- 1.2药物组的平均基线IOP为24.3 +/- 6.0 mmHg，在3年后，0.5 +/- 0.7药物组的平均IOP降至13.8 +/- 3.2 mmHg。所有研究眼的眼压和用药结果在所有时间间隔内均较基线显著降低（p < 0.00001）。术后后期并发症包括白内障（19.1%）和短暂性IOP升高（1.8%）。在成人开角型青光眼患者中，导管成形术显示出显著和持续的IOP降低，并具有良好的短期和长期安全性。
To report 3-year results investigating the safety and efficacy of canaloplasty, a procedure involving circumferential viscodilation of Schlemm's canal and tensioning of the inner canal wall to treat open-angle glaucoma.This was a prospective, multi-center, interventional study of 109 eyes of 109 adult, open-angle glaucoma patients undergoing canaloplasty or combined cataract-canaloplasty surgery. Qualifying preoperative intraocular pressures (IOP) were at least 16 mmHg with historical IOPs of at least 21 mmHg with or without medical therapy. A flexible microcatheter was used to viscodilate the full circumference of the canal and to place a trabecular tensioning suture. Primary outcome measures included IOP, glaucoma medication usage, and adverse events.Eyes with canaloplasty showed a mean baseline IOP of 23.0 +/- 4.3 mmHg and mean glaucoma medication usage of 1.9 +/- 0.7 medications, which decreased to a mean IOP of 15.1 +/- 3.1 mmHg on 0.9 +/- 0.9 medications at 3 years postoperatively. Eyes with combined cataract-canaloplasty surgery showed a mean baseline IOP of 24.3 +/- 6.0 mmHg on 1.5 +/- 1.2 medications, which decreased to a mean IOP of 13.8 +/- 3.2 mmHg on 0.5 +/- 0.7 medications at 3 years. Intraocular pressure and medication use results for all study eyes were significantly decreased from baseline (p < 0.00001) at all intervals. Late postoperative complications included cataracts (19.1%) and transient IOP elevation (1.8%).Canaloplasty demonstrated significant and sustained IOP reductions accompanied by an excellent short- and long-term safety profile in adult patients with open-angle glaucoma.