Prospective, multicenter, randomized comparison of phaco and Schlemm's canal microstent vs phaco alone for lowering IOP at 24 months

Session Details

Session Title: Presented Poster Session: Glaucoma

Session Date/Time: Monday 07/09/2015 | 09:30-11:00

Paper Time: 10:30

Venue: Poster Village: Pod 4

First Author: : J.Garcia Feijoo SPAIN

Co Author(s): :    N. Pfeiffer   J. Martinez de la Casa   A. Fea   H. Lemij   J. Larrosa Poves   S. Gandolfi

Abstract Details

Purpose:

Compare the reduction of washed out diurnal IOP and hypotensive medication due to a Schlemm's canal microstent in patients with open angle glaucoma undergoing concurrent phacoemulsification to phacoemulsification alone for 2 years after surgery.

Setting:

University Eye Clinic, Salzburg, Austria Specialized Hospital for Active Treatment of Ophthalmologic Diseases, Bulgaria, Sofia, Schlosspark-Klinik, Department of Ophthalmology, Berlin, Germany Augenklinik Cham, Cham, Germany Klinik fur Augenheilkunde, Campus Luebeck, Luebeck, Germany Klinik fur Augenheilkunde, Dietrich Bonhoeffer Klinikum, Neubrandenburg Germany San Carlos Clinical Hospital, Madrid, Spain

Methods:

Prospective, controlled, randomized clinical study in subjects with OAG and cataract at 7 clinical centers. Qualified subjects were washed out of hypotensive medications prior to surgery. Preoperative washed out diurnal IOP was measured using Goldmann tonometry. After cataract surgery, subjects were randomly assigned to receive the Hydrus microstent (Ivantis, Inc) or no treatment. Follow up was conducted at 1 day, 7 days, and 1, 3, 6, 12, 18, and 24 months. Examinations included IOP, medication use, and changes in visual status and ocular health. Wash out and diurnal Goldmann tonometry was repeated at the 12 and 24 months.

Results:

100 eyes from 100 subjects were randomized in the study. There were no significant differences between groups in age, sex, ethnicity distribution or baseline visual acuity or glaucoma severity. Screening IOP was 18.8 ± 3.6 mmHg on 2.0 ± 1.0 glaucoma medications. Pre operative washed-out IOP was 26.3±4.4 in the Hydrus group and 26.6±4.2 mm Hg in the phaco group. At 2 years, medication use was 50% lower in the Hydrus group and the proportion of patients with a 20% drop in washed out IOP was 80% in the Hydrus group compared to 46% in the phaco group (p=0.0004).

Conclusions:

Phaco with a Schlemm's canal microstent significantly lowered IOP and medication usage compared to phaco alone through 24 months in patients with OAG and cataract.

Financial Interest:

NONE