Continued long-term results after implantation of a single trabecular bypass stent during small incision cataract surgery in patients with glaucoma or ocular hypertension

Session Details

Session Title: Combined Cataract Surgery: Techniques/Practice Styles

Session Date/Time: Tuesday 13/09/2016 | 14:00-16:00

Paper Time: 14:00

Venue: Auditorium C6

First Author: : T.Neuhann GERMANY

Co Author(s): :                        

Abstract Details

Purpose:

To assess long-term efficacy and safety after implanting a single iStent® (Glaukos) during small incision cataract surgery in subjects with primary open angle glaucoma (POAG), pseudoexfoliation glaucoma, ocular hypertension and secondary, post-traumatic glaucoma. The iStent can reestablish physiologic outflow and reduce intraocular pressure (IOP) via creation of a direct access to Schlemm's canal.

Setting:

AaM Augenklinik am Marienplatz, Munich, Germany

Methods:

Following phacoemulsification and intraocular lens (IOL) implantation through a temporal, limbal incision, a single iStent was implanted through the same incision in a consecutive series of 62 eyes (43 subjects). With long-term follow-up through 4 years completed in 38 subjects, continued postoperative follow-up for the entire set of cases is ongoing. Intraocular pressure (IOP), topical ocular hypotensive medication use, best corrected visual acuity (BCVA), cup to disc (CD) ratio, complications and adverse event assessment were included in the preoperative and postoperative measurements.

Results:

Sixty-three percent (n=39) of eyes had POAG, and 40% (n=25) had prior laser or incisional glaucoma surgeries. Mean preoperative IOP was 24.1 ± 6.9 mmHg on 1.9 ± 0.9 medications. Sixty-six percent (n=41) were taking ≥ 2 medications preoperatively. Mean IOP reduced to 14.8 ± 4.2 mmHg, 14.5 ± 2.2 mmHg, 14.9 ± 2.3 mmHg and 15.6 ± 3.6 mmHg postoperative at years 1, 2, 3 and 4 with reduction in medications to 0.3 ± 0.6, 0.3 ± 0.4, 0.3 ± 0.5 and 0.5 ± 0.6. No operative or postoperative stent-related adverse events occurred. Five patients required secondary glaucoma surgeries.

Conclusions:

In our series, outcomes through 4 years after use of iStent during cataract surgery showed long-term, stable reduction in IOP and medications, with no intra- or postoperative complications typically seen with conventional glaucoma surgeries. We have found the iStent to be a safe and effective treatment option through 3 years postoperative in patients with ocular hypertension or open-angle glaucoma. Longer term data past 48 months will be presented.

Financial Disclosure:

NONE