Posters

Evaluation of outcomes for patients undergoing iStent inject® trabecular micro-bypass for the treatment of ocular hypertension and glaucoma

Poster Details

First Author: S.Zormpas UK

Co Author(s):    A. Matsou   R. Petrarca   C. Panos              

Abstract Details

Purpose:

i-stent inject trabecular micro-bypass is a minimally invasive glaucoma surgical (MIGS) device aiming to lower IOP or reduce dependence on topical glaucoma medication. It is indicated in the treatment of patients with ocular hypertension and early to moderate glaucoma who have failed previous medical treatments. It can be inserted during cataract surgery or as a standalone procedure. A growing body of evidence suggests meaningful reduction of IOP and medication use. The aim of this study was to assess and report our experience on the safety and efficacy of implantation of two second-generation trabecular micro-bypass stents in our cohort of patients.

Setting:

Epsom and St Helier NHS Trust

Methods:

Retrospective study which included all i-stent inject insertion procedures performed over a 6 month period. Baseline best corrected visual acuity (BCVA) and intraocular pressure were recorded for all patients. Assessment of safety of treatment included BCVA at baseline and then at month 3 and 6 post treatment, intra and post-operative complications. Evaluation of efficacy comprised IOP reduction at 3 and 6 months post-operatively and/or reduction of dependence on topical medication.

Results:

50 eyes of 46 patients with ocular hypertension or early/moderate glaucoma were enrolled (N=50). 6 patients had a standalone i-stent inject insertion and 44 had a combined procedure with cataract surgery. Mean IOP reduced from 19.9mmHg at baseline to 15.6mmHg at 3 months after the procedure and to 15.5mmHg at 6 months. Number of topical medication reduced considerably from a mean number of 2.2 at baseline to 1 medication 3 months post-op and to 0.2 medications 6 months post-op. There was a favourable safety profile with no recorded drop in BCVA and no intra- or post- operative complications.

Conclusions:

Our cohort of patients showed promising results with i-stent inject as primary surgical intervention both in terms of safety and efficacy with substantial reduction in IOP and medication use. Our results suggest that the implantation of two second-generation trabecular micro-bypass stents can be employed as first line surgical intervention in patients with early to moderate glaucoma to adequately control IOP and improve quality of life by considerably reducing the burden of topical IOP lowering treatment. Long term follow up will shed more light into the sustainability of the treatment.

Financial Disclosure:

None