Single-surgeon experience with iStent trabecular micro-bypass implanted in conjunction with cataract surgery: long-term outcomes

Session Details

Session Title: Presented Poster Session: Glaucoma II

Venue: Poster Village: Pod 3

First Author: : P.Singh USA

Co Author(s): :    M. Gallardo                       

Abstract Details

Purpose:

This case series aims to evaluate the outcomes of a single surgeon’s experience with a trabecular micro-bypass stent (iStent®) in combination with cataract surgery to treat a predominantly Hispanic patient cohort with OAG.

Setting:

Private-practice ophthalmology center in El Paso, Texas.

Methods:

Consecutive series of 168 eyes classified by surgical goal into 2 groups: 1) Controlled (CON): IOP <18 mmHg on ≥1 med and goal to reduce medication, 2) Uncontrolled (UNCON): IOP ≥18 mmHg and/or maximum tolerated medications and goal to reduce IOP. All patients were implanted with one iStent during cataract surgery.  To date, 87 eyes (49 CON, 38 UNCON) have been followed through 3 years and 47 eyes (27 CON, 20 UNCON) have been followed through 5 years. IOP, medications, VF, RNFL, C/D ratio, and complications/interventions were assessed.

Results:

Patients were predominantly Hispanic (78% CON, 68% UNCON). At 3 years, mean medications in CON eyes decreased by 77% (0.58 vs 2.57 preoperatively). In UNCON eyes, mean IOP decreased by 31% (13.4 mmHg vs 19.4 preoperatively), with 92% of eyes achieving IOP ≤18 mmHg. UNCON eyes also had 45% medication reduction (1.2 vs 2.2 medications preoperatively). In the subset of eyes reaching 5 years, mean medications in CON eyes decreased to 0.85 vs 2.48 preoperatively. In UNCON eyes, IOP was reduced (13.7 mmHg vs 20.0) as well as  medications (1.5 vs 2.7 medications).     Favorable safety included stable VF and RNFL.

Conclusions:

In this case series comprised of primarily a Hispanic population with OAG, IOP and medication reduction were safely sustained through 3 years after implantation of an iStent during cataract surgery. VF and RNFL remained stable over the course of 3 years following stenting indicating stabilization of function and structure of the condition. Evaluation of the cohort of eyes with 5-year outcomes demonstrates durable performance through 5 years.

Financial Disclosure:

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