Personal experience with second-generation trabecular micro-bypass stents (iStent inject®) in patients with glaucoma: 4-year follow-up

Session Details

Session Title: Microinvasive Glaucoma Surgery

Session Date/Time: Sunday 15/09/2019 | 14:00-16:00

Paper Time: 14:12

Venue: Free Paper Forum: Podium 4

First Author: : F.Hengerer GERMANY

Co Author(s): :                                 

Abstract Details

Purpose:

To evaluate IOP, medication usage, and safety after implantation of two second-generation trabecular micro-bypass stents (iStent inject®) either with cataract surgery or as a standalone procedure in patients with glaucoma.

Setting:

Department of Ophthalmology, Ruprecht-Karls-University Heidelberg, Germany

Methods:

This prospective, consecutive case series by a single surgeon in Germany evaluates outcomes after implanting iStent inject in a total of 125 eyes with glaucoma (predominantly POAG, with other sub-types such as pseudoexfoliative and pigmentary glaucoma included). Approximately 50% of eyes had history of prior glaucoma surgery. A total of 46 eyes have completed 4 years of follow-up, and follow-up continues. IOP, medication usage, visual acuity, C:D ratio, VF MD, and adverse events were evaluated

Results:

Preoperative mean IOP was 23.5±6.2 mmHg with 83% of eyes on a mean of 2.7 medications (n=125). Mean IOP was reduced to15.0±2.6 mmHg at 1 year (n=113), 14.6±2.4 mmHg at 2 years (n=98), 14.6±2.0 mmHg at 3 years (n=75), and 13.9±1.8 mmHg at 4 years (n=46), representing 36-41% reductions. All eyes achieved 4-year IOP ≤18 mmHg. Medications decreased to 0.6 at 4 years (n=46), with 96% of eyes using 0-1 medication. Favorable safety included minimal adverse events; stable visual acuity, C:D ratio, and VF MD; five eyes with additional glaucoma surgery for disease progression

Conclusions:

Two iStent inject devices implanted in combination with cataract surgery or as a standalone procedure in in eyes with various types of glaucoma resulted in clinically meaningful, long-term reductions in IOP and medications through 4 years postoperative, together with favorable safety. These data add to the considerable evidence base showing the iStent inject to be a promising treatment option for treatment of glaucoma.

Financial Disclosure:

None