Long-term outcomes following implantation of iStent during small incision cataract surgery in patients with glaucoma

Session Details

Session Title: Cataract Surgery Special Cases II

Session Date/Time: Monday 15/09/2014 | 16:30-18:30

Paper Time: 17:06

Venue: Auditorium

First Author: : T.Neuhann GERMANY

Co Author(s): :                  

Abstract Details

Purpose:

To evaluate long-term safety and efficacy following implantation of a single iStent® during small incision cataract surgery in subjects with primary open angle glaucoma, pseudoexfoliation glaucoma, ocular hyptertension and secondary, post-traumatic glaucoma. By creating a direct access to Schlemm's canal, the iStent can reestablish physiologic outflow and reduce intraocular pressure (IOP).

Setting:

AaM Augenklinik am Marienplatz Munich, Germany

Methods:

The iStent is preloaded in a single-use sterile applicator to facilitate manipulation and placement into Schlemm's canal. In a consecutive series of 62 eyes of 43 subjects. a single iStent was implanted through the same temporal, limbal incision used for cataract surgery via phacoemulsification Long-term follow-up through 3 years has been obtained in 20 subjects, and continued postoperative follow-up on the entire set of cases is continuing. Preoperative and postoperative measurements included intraocular pressure (IOP), use of topical ocular hypotensive medications, best corrected visual acuity (BCVA), cup to disc ratio, complications and adverse event assessment

Results:

Thirty-nine eyes (62.9%) presented with open-angle glaucoma, and 25 eyes (40%) had undergone prior laser or incisional glaucoma surgeries. Mean preoperative IOP was 24.1 (SD 6.9) mmHg on a mean of 1.9 medications (SD 0.9). Most eyes (66%, n=41) were taking 2 or more medications preoperatively. Mean IOP reduced to 15.5 mmHg on the first day postoperative and was 15.6 mmHg at 36 months. At the 36-month exam, 74% of eyes were not taking medication. No intra- or postoperative complications typically seen with conventional glaucoma surgeries occurred after stent implantation.

Conclusions:

The iStent is a safe and effective treatment option through 3 years postoperative in patients with ocular hypertension or open-angle glaucoma. In our series it reduced IOP and the need for ocular hypotensive treatment and/or significantly reduced the number of hypotensive medication. Longer term data past 36 months will be presented.

Financial Interest:

NONE