Management of open-angle glaucoma in cataract patients using Kumar’s 3rd generation stainless steel spiral Schlemm’s canal expander during small incision cataract surgery

Session Details

Session Title: Combined Cataract Surgery: Techniques/Practice Styles

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

Paper Time: 14:06

Venue: Auditorium C6

First Author: : V.Kumar RUSSIA

Co Author(s): :    M. Frolov   G. Dushina   A. Belodedova   A. Shradqa           

Abstract Details

Purpose:

To evaluate the safety and efficacy of Kumar’s 3rd generation Schlemm’s canal expander (SCE) implantation in decreasing intraocular pressure (IOP) and hypotensive medication(s) use in cataract patients suffering from open angle glaucoma (OAG).

Setting:

Ophthalmic unit of Skhodnya city hospital, Moscow province; People’s friendship university of Russia Medical Institute Department of Ophthalmology, Moscow, Russian Federation.

Methods:

Medical records of 41 patients having undergone implantation of Kumar’s 3rd generation SCE during cataract surgery between May, 2014 and September, 2015 were retrospectively evaluated. The 5mm long device, made from 0.05mm thick medical grade stainless steel wire, having inner lumen diameter of .15mm and outer - .25mm was implanted into SC ab externo after completion of cataract surgery. Outcome measures were IOP change, number of glaucoma medications pre- and postoperatively and complications. Success rates were evaluated using World Glaucoma Association guidelines. A paired t-test was used for analysis. Results were significant when p less than .05.

Results:

Mean preoperative IOP was 21.4+/–5.7mmHg and mean number of medications - 2.4+/–1.0. At 1 (n=38), 3 (n=37), 6 (n=32) and 12 months (n=13) mean IOP reduced by 42.2+/–17.3, 42.7+/–18.9, 42.4+/–16.3 and 39.7+/–20.4% and was 11.9+/–3(p=4.47E-14), 11.8+/–3.9(p=1.81E-12), 11.8+/–2.6(p=4.20E-12) and 12.6+/–3.1mmHg (p=.000009); use of medications reduced to 0 +/–.2(p=3.32E-23), .2+/–.6(p=2.09E-18), .3+/–.7(p=1.64E-14) and .8+/–1(p=.00143); complete success achieved in 97.4 (37/38), 86.5 (32/37), 81.3 (26/32) and 53.8% (7/13) cases respectively. Intraoperatively, microperforation occurred in 4 cases (9.8%). Postoperatively, in 4 cases (9.8%) YAG laser trabeculopuncture was required to control IOP.

Conclusions:

Ab externo implantation of Kumar’s 3rd generation stainless steel spiral SCE was safe to implant during small incision cataract surgery. It was effective in decreasing IOP from the baseline and hypotensive medication use in cataract patients suffering from OAG.

Financial Disclosure:

NONE