Effectiveness of Microinvasive Glaucoma Surgery in the United States

Intelligent Research in Sight Registry Analysis 2013e2019 Shuang-An Yang, MD, MPH,1,2 Elizabeth C. Ciociola, BA,3 William Mitchell, MBBS, MPH,2 Nathan Hall, MSc,4 Alice C. Lorch, MD, MPH,4 Joan W. Miller, MD,4 David S. Friedman, MD, PhD,4 Michael V. Boland, MD, PhD,4 Tobias

Ophthalmology, 2023-03-01, 卷 130, 期 3, 頁面 242-255, Copyright © 2022 American Academy of Ophthalmology

英文摘要

Summary: This study aimed to evaluate the effectiveness of micro-invasive glaucoma surgery (MIGS) with and without concurrent phacoemulsification. In current United States clinical practice, MIGS has substantially lower reoperation rates when performed with phacoemulsification, particularly for endoscopic cyclophotocoagulation (ECP) and goniotomy or canaloplasty. However, the efficacy of these procedures has not been fully demonstrated, as most published studies to date are retrospective series without control groups. Furthermore, little is known about patient factors predicting positive outcomes after MIGS procedures. The results showed that ECP (94%) and goniotomy or canaloplasty (76%) were more likely to be performed with phacoemulsification than ab interno Xen implantation (29%). Lower reoperation rates were observed in patients undergoing MIGS with concurrent phacoemulsification. However, nearly one-quarter of patients undergoing standalone ab interno Xen implantation and goniotomy or canaloplasty required reoperation within two years. Future studies are needed to determine the role of MIGS in different types of glaucoma.

中文摘要

摘要：本研究評估了微創性青光眼手術（MIGS）與是否合併晶状体超声乳化术（phacoemulsification）的有效性。在美國目前的臨床實踐中，與phacoemulsification一起進行的MIGS具有顯著較低的二次手術率，尤其對於內窺鏡下睫狀體光凝固術（ECP）和切口房角手術或管成形術。然而，迄今為止發表的大多數研究都是沒有對照組的回顧性系列，因此尚未充分證明其效能。此外，對於MIGS手術後預測良好結果的患者因素知之甚少。結果顯示，ECP（94%）和切口房角手術或管道成形術（76%）比內窺鏡下Xen凝膠支架植入術（29%）更可能與phacoemulsification一起進行。在MIGS與phacoemulsification聯合進行的患者中，觀察到較低的二次手術率。然而，單獨進行內窺鏡下Xen植入術和切口房角手術或管道成形術的近四分之一患者在兩年內需要再次手術。未來有必要進行更多研究來確定MIGS在不同類型的青光眼中的作用。