Long-term findings following micro-invasive glaucoma surgery (MIGS) with two trabecular micro-bypass stents and travoprost in OAG not controlled on two preoperative medications

Session Details

Session Title: Modarated Poster Session: Hot and New

Session Date/Time: Monday 07/09/2015 | 14:00-15:00

Paper Time: 14:50

Venue: Poster Village: Pod 1

First Author: : D.Chang USA

Co Author(s): :                  

Abstract Details

Purpose:

Earlier work by the Micro-invasive glaucoma surgery (MIGS) Study Group showed intraocular pressure (IOP) and medication reduction through 18 months following ab interno implantation of 2 trabecular bypass stents as a stand-alone surgical procedure with postoperatively administered travoprost in OAG eyes not controlled on 2 preoperative ocular hypotensive medications. This current report summarizes findings through 3 years postoperative in this non-comparative series of 39 eyes. Follow-up through 5 years postoperative is ongoing.

Setting:

Surgeons visiting from eight countries and staff surgeons in Armenia comprise the MIGS Study Group. The S.V. Malayan Ophthalmological Center in Yerevan, Armenia is the investigational setting at which surgeries by the visiting and staff surgeons have been performed.

Methods:

This prospective study enrolled 39 qualified phakic eyes with OAG not controlled on 2 medications, preoperative medicated IOP of 18 - 30 mmHg, and IOP following medication washout of 22 - 38 mmHg. Two trabecular bypass stents were implanted through a clear corneal incision as a stand-alone procedure, and travoprost was prescribed. Postoperative examination was planned at Day 1, Week 1, Months 1, 3, 6, and semi-annually through 5 years, with 1-month medication washout and follow-up examination at annual visits. Efficacy and safety evaluations included IOP, medication use, fundus, slit-lamp, ocular complications, BCVA, visual field, C/D ratio and corneal thickness.

Results:

By 36 months postoperative 37 subjects presented for evaluation, one subject had died, and one subject was lost to follow-up. Mean medicated IOP was 25.3 (SD 1.8) mm Hg preoperatively on 2 medications and 14.0 (SD 2.4) mmHg on 1 medication at 36 months. Following a 1-month medication washout, mean IOP at 37 months was 17.7 (SD 2.1) mmHg. Long-term postoperative adverse events included cataract surgery in 3 eyes due to cataract progression over the 3-year follow-up time frame, and trabeculectomy in 1 eye with uncontrolled IOP of 25 mmHg. No device-related adverse events occurred.

Conclusions:

Reduction in both IOP reduction and medication with a favorable safety profile were shown through 3 years after implantation of 2 trabecular bypass stents as a stand-alone procedure with postoperative travoprost in OAG eyes non controlled on 2 preoperative medications. These findings demonstrate the long-term performance of trabecular bypass as a safe and effective treatment for patients with OAG.

Financial Interest:

One of the authors receives consulting fees, retainer, or contract payments from a competing company