Initial experience with combined cataract surgery and minimally invasive glaucoma surgery: my first 100+ cases

Session Details

Session Title: Cataract Surgery & Glaucoma

Session Date/Time: Sunday 23/09/2018 | 14:00-16:00

Paper Time: 14:06

Venue: Room A3, Podium 1

First Author: : A.Bansal UK

Co Author(s): :    L. Akshatha Ranganathan                    

Abstract Details

Purpose:

To evaluate the safety and efficacy of combined cataract surgery with Minimal invasive glaucoma surgery with iStent trabecular bypass, Xen Subconjunctival Microshunt and Trabectome Ab interno Trabeculotomy. To assess the efficacy by IOP reduction and reduction in need of drops and safety by complications and need for secondary surgical procedures. Number of hospital visits in initial postoperative period is also assessed

Setting:

University Hospital Coventry & Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX

Methods:

This continuous retrospective observational study includes 106 eyes with OAG that underwent combined cataract surgery and Minimally Invasive Glaucoma Surgery in form of iStent trabecular bypass, Xen Subconjunctival Microshunt and Trabectome Ab interno Trabeculotomy. Data included basic demographics, intraocular pressure (IOP), best corrected visual acuity (BCVA, logMAR), intra-operative data and surgical complications. Success was defined as IOP reduction of 20%, and/or reduction of glaucoma medication by one. Failure is defined as non achievement of the success criteria , sight threatening complications and /or further requirement of pressure-lowering surgeries performed. Uptodate results will be presented.

Results:

106 consecutive cases performed by one surgeon were included, These included cataract surgery combined with iStent (52), Xen Microshunt (28) and Trabectome (24). This is a continuous audit and follow up period is 3 to 60 months. All modalities led to greater than 20% reduction in IOP in more than 80% patients, being highest in the Xen cases. The need for revision was seen only in Xen with 28.5% cases requiring needling and/or revision of bleb. The number of postoperative visits was highest in the Xen Subconjunctival Microshunt groups. No cases with sight threatening complications were seen.

Conclusions:

Initial results with combined cataract surgery with Minimal invasive glaucoma surgery with iStent trabecular bypass, Xen Subconjunctival Microshunt and Trabectome Ab interno Trabeculotomy show encouraging results without any sight threatening complications. The difference in efficacy and postoperative course would suggest customising the care according to specific patient profile.

Financial Disclosure:

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