Influence of oral anticoagulation on success rates and risk of bleeding events after iStent inject implantation combined with phacoemulsification.
Influence of oral anticoagulation on success rates and risk of bleeding events after iStent inject implantation combined with phacoemulsification.
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DOI：
10.1007/s00417-020-04894-3
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Dietlein TS
中科院分区：
文献类型：
--
作者：
Widder RA;Lappas A;Rennings C;Hild M;Roessler GF;Dietlein TS
我们进行了一项回顾性研究，以评价与匹配对照组相比，接受iStent注射联合超声乳化术并接受抗凝治疗的患者的降眼压效果、成功率和出血事件风险。在这项回顾性研究中，64只眼睛在两个中心接受了iStent注射植入联合超声乳化白内障吸除术。其中32眼在抗凝治疗的同时接受手术治疗，另32眼作为对照组，视力、眼压和药物评分匹配。成功定义为标准A和B（IOP < 18/21 mmHg，IOP降低> 20%，无再手术）和标准C（IOP ≤ 15 mmHg，IOP降低≥ 40%，无再手术）。本研究的临床目的是确定研究组和对照组在IOP、药物评分以及术中和术后出血事件频率方面的差异。平均随访1年后，该组64只眼的IOP从20.1 ± 4.8 mmHg降至14.5 ± 3.7 mmHg，降低了28%。药物评分从2.1 ± 1.1降至1.3 ± 1.2，降低了38%。使用和不使用抗凝剂的两组在术后IOP、药物评分、成功率或出血事件数量方面没有显著差异。我们得出结论，在白内障手术联合iStent注射中，可能不需要停用抗凝剂。在青光眼手术中，当抗凝治疗不应中断且目标压力不是很低时，它可能是一个很好的选择。
We conducted a retrospective study to evaluate the intraocular pressure (IOP) lowering effect, the success rates, and the risk of bleeding events of patients receiving an iStent inject combined with phacoemulsification under anticoagulation therapy compared with a matched control group. In this retrospective study, sixty-four eyes underwent an iStent inject implantation combined with phacoemulsification at two centers. Thirty-two eyes received surgery while under anticoagulation therapy, and another thirty-two eyes served as a control group matched for visual acuity, IOP, and medication score. Success was defined as criteria A and B (IOP < 18/21 mmHg, > 20% IOP reduction, no resurgery) and criteria C (IOP ≤ 15 mmHg, IOP reduction ≥ 40%, no resurgery). The clinical goal of the study was to determine the difference between the study and control groups with respect to IOP, medication score, and the frequency of intraoperative and postoperative bleeding events. After a mean follow-up time of 1 year, the IOP lowered 28% from 20.1 ± 4.8 to 14.5 ± 3.7 mmHg in the group of 64 eyes. The medication score lowered 38% from 2.1 ± 1.1 to 1.3 ± 1.2. The two groups with and without anticoagulant agents did not significantly differ in postoperative IOP, medication score, success rates, or number of bleeding events. We conclude that in cataract surgery combined with the iStent inject a discontinuation of anticoagulant agents might not be necessary. It might be a good option in glaucoma surgery when anticoagulation treatment should not be interrupted and the target pressure is not very low.
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