iStent inject trabecular microbypass stent implantation with cataract extraction in open-angle glaucoma:early clinical experience

Background:Retrospective,consecutive case series to evaluate the implantation of two second-generation trabecular microbypass stents in combination with cataract surgery in a real-world,clinical setting.Methods:The series included 56 eyes implanted with the iStent inject device with phacoemulsification.The series consisted of eyes with primary open-angle glaucoma(n=52)and pseudoexfoliative glaucoma(n=4).Primary outcome measures included intraocular pressure(IOP)and number of glaucoma medications.Safety outcomes included the need for secondary surgical intervention and the incidence of IOP spikes≥10 mmHg and≥15 mmHg.Results:IOP was reduced by 21%to 14.7±2.9 mmHg(p<0.01)at 6 months postoperative from 18.7±5.8 mmHg at baseline.Preoperatively,the mean number of glaucoma medications was 1.5±0.9 and reduced by 39%to 0.9±1.2(p<0.01)at 6 months.At 6 months,68%of eyes had an IOP≤15 mmHg,increased from 30%at baseline.55%of eyes were medication-free at 6 months,up from 18%at baseline.There were no severe postoperative complications.No eyes underwent an additional glaucoma procedure.Conclusions:Implantation of the iStent inject device with concomitant cataract surgery effectively provides a sustained reduction in IOP with a markedly improved medication burden out to 6 months postoperative.The safety profile is excellent.

iStent inject trabecular microbypass stent implantation with cataract extraction in open-angle glaucoma:early clinical experience

Background:Retrospective,consecutive case series to evaluate the implantation of two sec on d-generation trabecular microbypass stents in combination with cataract surgery in a real-world,clinical setting.Methods:The series in eluded 56 eyes implanted with the iSte nt inject device with phacoemulsification.The series consisted of eyes with primary open-angle glaucoma(n=52)and pseudoexfoliative glaucoma(n=4).Primary outcome measures included intraocular pressure(IOP)and number of glaucoma medications.Safety outcomes included the need for secondary surgical intervention and the incidence of IOP spikes>10 mmHg and>15 mmHg.Results:IOP was reduced by 21%to 14.7±2.9 mmHg(P<0.01)at 6 months postoperative from 18.7±5.8 mmHg at baseline.Preoperatively,the mean number of glaucoma medications was 1.5±0.9 and reduced by 39% to 0.9±1.2(P<0.01)at 6 months.At 6 months,68%of eyes had an IOP<15 mmHg,increased from 30%at baseline.55%of eyes were medicati on-free at 6 months,up from 18%at baseline.There were no severe postoperative complications.No eyes underwent an additional glaucoma procedure.Conclusions:Implantation of the iStent inject device with concomitant cataract surgery effectively provides a sustained reduction in IOP with a markedly improved medication burden out to 6 months postoperative.The safety profile is excellent.

经鼻导管微旁流式PETCO_(2)监测在肥胖患者麻醉中的应用

目的 探究与分析经鼻导管微旁流式PETCO_(2)监测在非气管插管静脉麻醉肥胖患者中的应用价值。方法 方便选取2018年5月—2021年5月在黑龙江省医院行非气管插管静脉全麻的择期手术患者98例,采用随机数字表法将其分为对照组和观察组,各49例。对照组给予经鼻导管吸氧,观察组在其基础上给予经鼻导管微旁式PETCO_(2)监测,对比两组低氧血症、面罩加压、托下颌率、挤压胸廓辅助呼吸率及苏醒期各指标时间。结果 观察组低氧血症、面罩加压分别为6.12%、2.04%低于对照组的20.41%、16.33%,托下颌率及挤压胸廓辅助呼吸率为30.61%、34.69%高于对照组的12.24%、10.20%,差异有统计学意义(χ^(2)=4.346、4.404、4.909、8.440,P<0.05)。观察组对刺激有反应的时间、清醒时间、拔管时间、拔管延迟时间、离室时间分别为(10.77±2.30)、(15.05±1.67)、(16.55±1.38)、(3.40±0.74)、(28.40±1.52)min均短于对照组(15.89±2.25)、(19.82±1.48)、(24.20±1.96)、(3.79±0.92)、(36.99±2.73)min,差异有统计学意义(t=11.139、14.964、22.340、2.312、19.244,P<0.05)。结论 经鼻导管微旁流式PETCO_(2)监测在非气管插管静脉麻醉肥胖患者中的应用可有效帮助医护人员对其进行托下颌以及挤压胸廓等辅助呼吸处理,降低全麻择期手术中患者的低氧血症发生率以及面罩加压率,可缩短苏醒时间。