Evaluation of second-generation trabecular micro-bypass stents in patients with mild to severe glaucoma: a Canadian study

Session Details

Session Title: Presented Poster Session: Glaucoma

Venue: Poster Village: Pod 2

First Author: : P.Harasymowycz CANADA

Co Author(s): :    J. Lapointe                       

Abstract Details

Purpose:

To assess outcomes following implantation of two second-generation trabecular micro-bypass stents (iStent inject®) during cataract surgery in glaucoma patients with mild to severe glaucoma.

Setting:

Université de Montréal

Methods:

Data were collected retrospectively from electronic files from a single ophthalmology clinic in Montréal. Patients with primary open angle glaucoma (53.8%), normal tension glaucoma (14%), primary angle closure glaucoma (20.5%), pseudoexfoliative (7%) and pigmentary glaucoma (2.9%) were included. Treatment outcomes analyzed included intraocular pressure (IOP) and glaucoma medication usage at baseline (preoperative) compared to postoperative measures. The per-protocol analysis reports outcomes at 6 months to 1 year with longer term follow-up ongoing.

Results:

179 eyes of 105 patients were included in the analysis. The mean preoperative IOP was 16.2 mmHg on 2.3 glaucoma medications. Follow-up showed a significant reduction of mean IOP to 13.8 (~16% reduction from preoperative) and the medication burden was reduced to 1.3 drops. The required amount of topical ocular hypotensive medications was reduced by ≥1 in 84% of patients and by ≥2 in 40% of patients. All eyes were successfully implanted with no intraoperative complications. Six eyes (3%) required secondary glaucoma surgery; all of these eyes were deemed to have moderate to severe glaucoma.

Conclusions:

This retrospective case series demonstrates that combined cataract surgery and implantation of second generation trabecular micro-bypass (iStent inject) is an effective treatment modality for significantly reducing the medication burden and IOP in mild to severe glaucoma patients.

Financial Disclosure:

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