MIGS (microinvasive glaucoma surgery) with second-generation trabecular micro-bypass stents combined with topical prostaglandin in eyes with OAG on 2 preoperative medications: 42 month outcomes

Session Details

Session Title: Presented Poster Session: Ocular Pathologies

Venue: Poster Village: Pod 3

First Author: : R.Ang PHILIPPINES

Co Author(s): :                           

Abstract Details

Purpose:

This report evaluates 42-month follow-up outcomes for treatment with two trabecular micro-bypass stents (iStent inject®) implanted as a standalone procedure combined with topical prostaglandin in subjects with OAG on 2 preoperative medications. Standalone implantation of iStent inject combined with postoperative travoprost has been shown to safely reduce IOP and medication usage through 18 months.

Setting:

S.V. Malayan Ophthalmological Center in Yerevan, Armenia.

Methods:

This prospective study enrolled subjects with OAG on 2 ocular hypotensive medications and with IOP of 18-30 mmHg (medicated) and 22-38 mmHg (following medication washout). Two iStent inject stents were implanted as a standalone procedure, and topical travoprost was started on postoperative Day 1. Assessments performed over the course of the study included IOP, medication usage, adverse events, visual acuity, slit-lamp, gonioscopy, and funduscopy including optic nerve exams. Annual medication washouts were performed to assess unmedicated IOP. Postoperative safety and efficacy evaluation through 5 years is ongoing.

Results:

All 53 enrolled subjects completed follow-up out to 42 months. Mean medicated IOP at M42 is 12.4 mmHg compared to 19.7 preoperative on 2 meds (37% reduction) and 24.9 preoperative post-washout (50% reduction). At M36, 91% of eyes achieved IOP of ≤18 mmHg on travoprost and 88% achieved ≥20% reduction in mean IOP on travoprost compared to preoperative mean IOP on 2 meds. All eyes underwent uncomplicated implantation of iStent inject. Best-corrected VA, C/D ratio, and VF mean deviation remained stable throughout the study. Other than two reports of progression of pre-existing cataract, no other AEs have been reported.

Conclusions:

The findings from this study demonstrate the long-term safety and utility of iStent inject combined with a postoperative prostaglandin as a treatment for patients with OAG. In this cohort of eyes with OAG not controlled on 2 preoperative medications, treatment with iStent inject trabecular micro-bypass stents performed as a standalone procedure combined with postoperative topical travoprost resulted in safe and long-lasting clinically meaningful IOP and medication reduction through 42 months.

Financial Disclosure:

research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented