Açık Açılı Glokom Tedavisinde ab interno Jel İmplant Sonuçlarının Retrospektif İncelenmesi

Year 2021, , 137 - 142, 29.05.2021

Funda Dikkaya , Mehmet Kocabora Cemil Yılmazlı Sevil Karaman Erdur , Arzu Aşıcı

https://doi.org/10.29058/mjwbs.798960

Abstract

Öz
Amaç: Primer açık açılı glokom (PAAG) hastalarında 6 aylık takip sırasında preoperatif Mitomycin C enjeksiyonu ile Xen45 Jel Stent implantasyonunun göz içi basıncını(GİB) düşürme ve güvenlik profillerini değerlendirmek.
Gereç ve Yöntemler: Fakoemülsifikasyon ile kombine XEN45 Jel Stent ile ameliyat edilen 13 PAAG hastasının 14 gözünün kayıtları retrospektif olarak değerlendirildi. Takip süresince GİB değişiklikleri, tüm komplikasyonlar ve ek işlemler değerlendirildi. Çalışmada birincil değerlendirilen sonuç GİB idi. Tam başarı için belirlenen GİB hedefi ameliyat öncesine göre % 20'nin üzerinde bir düşüş ve herhangi bir glokom ilacı olmaksızın 6. ayda GİB≥6 ve ≤21 olarak tanımlandı. Yeterli başarı ise ilaçlı veya ilaçsız olarak 6. ayda GİB'de % 20'den fazla azalma ve GİB≥6 ve ≤21 olarak tanımlandı.
Bulgular: Ortalama preoperatif ilaçlı GİB, ortalama 2,6 ± 0,6 topikal anti-glokom molekülü ile beraber 28,4 ± 2,7 mmHg idi. Altı aylık takip süresinden sonra ortalama GİB, 0,4 ± 1,1 anti-glokom molekülü ile beraber 17,8 ± 1,5 mmHg'ye (ortalama GİB düşüşü % 37) düştü. 6 ay sonra tam başarı oranı % 42,8 ve yeterli başarı oranı %85,7 olarak bulundu. Toplamda sadece 2 hastaya (% 14,2) ek işlem (1 iğneleme ve 1 trabekülektomi) gerekti.
Sonuç: Çalışma, fako-katarakt cerrahisi ile kombine XEN45 Jel Stent implantasyonunun, kontrolsüz GİB durumunda olumlu bir güvenlik profili ve düşük komplikasyon oranı ile PAAG'da etkili bir cerrahi yöntem olabileceğini göstermiştir.

Keywords

Glokom, glokom drenaj implantları, Cerrahi

Retrospective Analysis of Outcomes with ab interno Gel Implant in the Treatment of Open Angle Glaucoma

Abstract

Purpose: To evaluate the intraocular pressure (IOP) lowering and safety profiles of the Xen45 Gel Stent implantation with preoperative Mitomycin C injection during a 6 months follow-up in patients with primary open-angle glaucoma (POAG).
Materials and Methods: Records of fourteen eyes of 13 POAG patients who underwent surgery with XEN45 Gel Stent combined with phacoemulsification were evaluated retrospectively. IOP changes, all complications and additional procedures during follow-up period were evaluated. Primary outcome measure was IOP, and the IOP target for complete success was defined as a postoperative IOP drop of more than 20% from preoperative baseline and IOP≥6 and ≤21 at 6 months without any glaucoma medications and qualified success was defined as a postoperative IOP reduction of more than 20% and IOP≥6 and ≤21 at 6 months with or without medications.
Results: Mean preoperative medicated IOP was 28.4 ± 2.7 mmHg with a mean of 2.6 ± 0.6 topical anti-glaucoma molecules. After 6 month follow-up period, mean IOP decreased to 17.8 ± 1.5 mmHg (mean IOP reduction of 37%) on 0.4 ± 1.1 antiglaucoma molecules. The complete success rate after 6 months was achieved in 42.8 % and qualified success in 85.7. Totally only 2 (14.2 %) patients required additional procedure (1 needling and 1 trabeculectomy).
Conclusions: The study showed that the XEN45 Gel Stent implantation combined with phaco-cataract surgery is an effective surgical method in POAG in case of uncontrolled IOP with a favorable safety profile and low complication rate.

Keywords

Glaucoma, Glaucoma drainage implants, Surgery

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