Outcomes with second-generation trabecular micro-bypass stents (iStent inject®) combined with cataract surgery in patients with glaucoma: an Australian experience

Session Details

Session Title: Microinvasive Glaucoma Surgery

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

Paper Time: 14:36

Venue: Free Paper Forum: Podium 4

First Author: : C.Clement AUSTRALIA

Co Author(s): :    A. Ioannidis   M. Shiu   D. Manning   F. Howes                    

Abstract Details

Purpose:

This retrospective case study evaluates 2 second-generation trabecular micro-bypass stents (iStent inject®) implanted in combination with cataract surgery in patients with ocular hypertension or mild to advanced glaucoma.

Setting:

Data from 5 surgeons at 5 ophthalmology centres in Australia.

Methods:

This multi-center, multi-surgeon, real-world study pools the data of 329 eyes of 215 patients who were successfully implanted with the iStent inject with cataract surgery. The majority of patients had OAG; however, other glaucoma types were included. Ocular assessments included IOP and medication use in addition to standard safety evaluations. This report includes outcomes data of 192 eyes with 1-year follow-up. Ongoing monitoring is planned for all 329 eyes implanted.

Results:

In the cohort of 192 eyes, mean IOP and medications reduced from 18.0±5.2 mmHg on 1.7±1.2 medications preoperatively to 14.1±3.0 mmHg on 0.6±1.0 medications at 1 year (22% and 67% reductions respectively). Medication was maintained or reduced in 98% of eyes, with 70% medication-free at 1 year (vs. 16% preoperatively). Favorable safety was consistent with routine cataract surgery, including stable VA, C/D ratio and VF; and no hypotony, PAS, stent obstruction, or microhyphema.

Conclusions:

Implantation of the iStent inject in combination with cataract surgery significantly and safely reduced IOP and medication burden in eyes with various types and severities of glaucoma and ocular hypertension. This real-world experience from Australian surgeons augments the existing evidence for iStent inject, a promising treatment option for glaucoma. This report represents the largest multi-center cohort of patients treated with iStent inject to date from the Asia-Pacific region.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented