Posters

Second generation trabecular micro-bypass stents and one postoperative prostaglandin in patients with open-angle glaucoma not controlled with two preoperative medications

Poster Details

First Author: A. Jünemann GERMANY

Co Author(s):                        

Abstract Details

Purpose:

An earlier study by the Micro-Invasive Glaucoma Surgery (MIGS) Study Group using first generation trabecular stents showed significant reduction in IOP and medication burden in OAG patients following implantation of 2 stents as a sole procedure and postoperative administration of 1 medication. Using a similar study design, we evaluated results with second generation stents (iStent inject, Glaukos) implanted as a sole procedure and 1 postoperative prostaglandin medication in 53 eyes with OAG not controlled with 2 preoperative medications.

Setting:

The MIGS Study Group is comprised of surgeons visiting from eight countries and staff surgeons in Armenia. These visiting and staff surgeons have performed surgeries at one investigational site – the S.V. Malayan Ophthalmological Center in Yerevan, Armenia.

Methods:

Key qualification criteria for study participation included phakic or pseudophakic subjects with OAG not controlled with 2 medications, medicated IOP between 18 mmHg and 30 mmHg and post-medication washout IOP between 22 mmHg and 38 mmHg. Two iStent inject stents were implanted ab internally as the only surgical treatment in eligible subjects. After surgery, travoprost was administered, with planned annual medication washouts to assess unmedicated IOP, followed by resumption of medication. Preoperative and postoperative exams through up to 5 years included assessment of IOP, medication use, adverse events, BCVA, CD ratio, visual field and pachymetry.

Results:

Fifty-one phakic and 2 pseudophakic patients were implanted with stents with no surgical complications. The mean age was 64.7 ± 9.6 years, mean preoperative medicated IOP was 19.7 ± 1.5 mmHg on two medications, and mean preoperative post-washout IOP was 24.9 ± 1.1 mmHg. All subjects have been followed through 18 months. Mean medicated IOP was 13.0 mmHg or lower through Month 18 (mean IOP = 12.9 ± 2.1 mmHg at Month 18). Mean unmedicated IOP at 13 months was 16.6 ± 1.4 mmHg. No postoperative ocular adverse events were reported

Conclusions:

In this series of patients with OAG not controlled on 2 preoperative medications, findings through 18 months showed IOP and medication reduction following implantation of iStent inject second generation stents as a standalone treatment with administration of one postoperative prostaglandin medication. These data suggest successful management of OAG to 13 mmHg or lower with reduced medication burden.

Financial Disclosure:

One or more of the authors travel has been funded, fully or partially, by a competing company