| Título: | A Randomized Trial of a Schlemm's Canal Microstent with Phacoemulsification for Reducing Intraocular Pressure in Open-Angle Glaucoma |
| Autores: | Pfeiffer, Norbert ; García Feijoo, Julián ; Martínez de la Casa, Jose Maria ; Larrosa Povés, José Manuel ; Fea, Antonio ; Lemij, Hans ; Gandolfi, Stefano ; Schwenn, Oliver ; Lorenz, Katrin ; Samuelson, Thomas W. |
| Tipo de documento: | texto impreso |
| Editorial: | Elsevier, 2015-07 |
| Dimensiones: | application/pdf |
| Nota general: | info:eu-repo/semantics/restrictedAccess |
| Idiomas: | |
| Palabras clave: | Estado = Publicado , Materia = Ciencias Biomédicas: Medicina: Cirugía , Materia = Ciencias Biomédicas: Medicina: Oftalmología , Tipo = Artículo |
| Resumen: |
Purpose: To assess the safety and effectiveness of the Hydrus Microstent (Ivantis, Inc, Irvine, CA) with concurrent cataract surgery (CS) for reducing intraocular pressure (IOP) in open-angle glaucoma (OAG). Design: Prospective, multicenter, randomized, single-masked, controlled clinical trial. Participants: One hundred eyes from 100 patients 21 to 80 years of age with OAG and cataract with IOP of 24 mmHg or less with 4 or fewer hypotensive medications and a washed-out diurnal IOP (DIOP) of 21 to 36 mmHg. Methods: On the day of surgery, patients were randomized 1:1 to undergo CS with the microstent or CS alone. Postoperative follow-up was at 1 day, 1 week, and 1, 3, 6, 12, 18, and 24 months. Washout of hypotensive medications was repeated at 12 and 24 months. Main Outcome Measures: Response to treatment was defined as a 20% or more decrease in washed out DIOP at 12 and 24 months of follow-up compared with baseline. Mean DIOP at 12 and 24 months, the proportion of subjects requiring medications at follow-up, and the mean number of medications were analyzed. Safety measures included change in visual acuity, slit-lamp observations, and adverse events. Results: The proportion of patients with a 20% reduction in washed out DIOP was significantly higher in the Hydrus plus CS group at 24 months compared with the CS group (80% vs. 46%; P = 0.0008). Washed out mean DIOP in the Hydrus plus CS group was significantly lower at 24 months compared with the CS group (16.9±3.3 mmHg vs. 19.2±4.7 mmHg; P = 0.0093), and the proportion of patients using no hypotensive medications was significantly higher at 24 months in the Hydrus plus CS group (73% vs. 38%; P = 0.0008). There were no differences in follow-up visual acuity between groups. The only notable device-related adverse event was focal peripheral anterior synechiae (1–2 mm in length). Otherwise, adverse event frequency was similar in the 2 groups. Conclusions: Intraocular pressure was clinically and statistically significantly lower at 2 years in the Hydrus plus CS group compared with the CS alone group, with no differences in safety. |
| En línea: | https://eprints.ucm.es/42609/1/Randomized%20trial-OPHT-2015.pdf |
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