Defining the role of ab externo Xen gel stent in glaucomatous eyes with prior failed surgical intervention.
Defining the role of ab externo Xen gel stent in glaucomatous eyes with prior failed surgical intervention.
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DOI：
10.1007/s00417-022-05857-6
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发表时间：
2023-03
影响因子：
2.7
通讯作者：
Feldman, Robert M.
中科院分区：
文献类型：
--
作者：
To, Lillian K.;Dhoot, Rupak K.;Chuang, Alice Z.;Karimaghaei, Sam;Guevara-Abadia, Francisco;Shah, Ruchi D.;Feldman, Robert M.
与传统青光眼引流装置 (GDD) 或连续波睫状体光凝术 (CPC) 相比，评估 Xen45 Gel 支架（Xen；艾尔建）对先前手术干预失败的眼睛的安全性和有效性。由于该人群进行额外手术的预期成功率较低，因此与标准护理手术方案进行比较至关重要。对先前接受过小梁切除术和/或 GDD 手术的眼睛进行外部经结膜 Xen 分流术的回顾性、单中心、病例对照研究。收集术后 18 个月的数据。失败的定义是术后 6 周后没有光感、需要额外的青光眼手术或眼压 (IOP) < 6 mmHg。其中包括 18 只 Xen 眼和 36 只与青光眼类型和既往青光眼手术相匹配的对照眼。 72% 患有原发性开角型青光眼，11% 患有葡萄膜炎，6% 患有原发性闭角型青光眼，6% 患有假性剥脱性青光眼，6% 患有色素性青光眼。每组中 56% 的眼睛先前接受过小梁切除术，28% 的 Xen 眼睛和 31% 的对照眼睛先前接受过 GDD，17% 的 Xen 眼睛和 14% 的对照眼睛同时接受过这两种手术。与对照组 (27.5±9.4，P=0.043) 相比，Xen 组的基线药物 IOP 较低 (21.8±7.2)。 Xen 第一年的累积故障率为 17%，对照组为 20%（P = 0.57）。对照组的平均生存时间为 14.1 (±1.5) 个月，对照组为 11.4 (±0.6) 个月。各组之间的轻微并发症发生率没有差异（P = 0.65），但Xen组的严重并发症（定义为威胁视力或需要在手术室进行手术干预）的发生率显着较低（P = 0.043）。当对额外的青光眼手术进行审查时，第一年的眼压、眼压变化、降低眼压药物的数量或较基线减少的药物数量没有差异。 Xen 分流器为当前标准护理提供了合理的替代方案，第一年的失败率相似，与 GDD 和 CPC 相比，IOP 降低效果不差，并且具有首选的安全性。
To evaluate the safety and efficacy of Xen45 Gel stent (Xen; Allergan) in eyes that have failed prior surgical intervention, compared to traditional glaucoma drainage device (GDD) or continuous-wave cyclophotocoagulation (CPC). Since this population has low expected success rates with additional surgery, it is vital to compare to standard-of-care surgical options. Retrospective, single-center, case–control study of ab externo transconjunctival Xen shunt in eyes that have previously undergone trabeculectomy and/or GDD surgery. Postoperative data were collected for 18 months. Failure was defined as no light perception, additional glaucoma surgery required, or intraocular pressure (IOP) of < 6 mmHg after 6 weeks postoperatively. Eighteen Xen eyes and 36 control eyes matched on both glaucoma type and previous glaucoma surgeries were included. Seventy-two percent had primary open angle glaucoma, 11% uveitic, 6% primary angle closure, 6% pseudoexfoliation, and 6% pigmentary glaucoma. Fifty-six percent of eyes in each group had prior trabeculectomy, 28% of Xen and 31% of control eyes had prior GDD, and 17% of Xen and 14% of control eyes had both. Baseline medicated IOP was lower in the Xen group (21.8 ± 7.2) compared to controls (27.5 ± 9.4, P = 0.043). The cumulative failure rate at year 1 was 17% for Xen and 20% for controls (P = 0.57). Mean survival time was 14.1 (± 1.5) months and 11.4 (± 0.6) months for controls. There was no difference in minor complication rates between groups (P = 0.65), but the Xen group had a significantly lower rate of serious complications (P = 0.043) defined as vision threatening or requiring surgical intervention in the operating room. When censored for additional glaucoma procedures, there were no differences at year 1 in IOP, change in IOP, number of IOP-lowering medications, or number of medications reduced from baseline. The Xen shunt provides a reasonable alternative to current standard of care, with a similar failure rate at year 1, with a noninferior IOP reduction compared to GDD and CPC, and a preferred safety profile.
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影响因子：
3.1
作者：
Shalaby, Wesam S.;Ganjei, Allen Y.;Wogu, Brian;Myers, Jonathan S.;Moster, Marlene R.;Razeghinejad, Reza;Lee, Daniel;Kolomeyer, Natasha N.;Eid, Tarek E.;Katz, L. Jay;Shukla, Aakriti G.
通讯作者：
Shukla, Aakriti G.
影响因子：
13.7
作者：
Tham, Yih-Chung;Li, Xiang;Cheng, Ching-Yu
通讯作者：
Cheng, Ching-Yu
DOI：
10.2147/opth.s354038
发表时间：
2022
期刊：
Clinical ophthalmology (Auckland, N.Z.)
影响因子：
--
作者：
通讯作者：
--
影响因子：
2
作者：
Karimi, Ayesha;Hopes, Marina;Lindfield, Dan
通讯作者：
Lindfield, Dan
影响因子：
2.9
作者：
Mansouri, Kaweh;Bravetti, Giorgio Enrico;Mermoud, Andre
通讯作者：
Mermoud, Andre