Posters

Single surgeon experience with second generation trabecular micro-bypass stents: long-term outcomes following implantation in patients with open-angle glaucoma

Poster Details

First Author: I.Conrad-Hengerer GERMANY

Co Author(s):    G. Auffarth                    

Abstract Details

Purpose:

The purpose of this study is to summarize safety and IOP-lowering outcomes through 3 years postoperative in patients with open-angle glaucoma following implantation of second generation trabecular micro-bypass stents (iStent inject®).

Setting:

Department of Ophthalmology, University of Heidelberg, Germany

Methods:

This was a consecutive series of cases in which the iStent inject (Glaukos), second generation trabecular micro-bypass stent, was implanted. 122 phakic or pseudophakic eyes of 89 patients with open-angle glaucoma (OAG) received two iStent inject devices as a sole procedure. The stents were implanted ab internally into Schlemm’s canal through a clear corneal incision using a single insertion instrument. A preoperative exam and postoperative exams through 3 years included assessment of IOP and medication use, and safety assessments including best-corrected visual acuity (BCVA), cup-disk (C/D) ratio, complications, and secondary surgeries.

Results:

Preoperative characteristics are: mean age 71.1±10.8 years, C/D ratio 0.8±0.1, IOP 24.3±4.9 mmHg, 83% of eyes used 3 or 4 medications, and 38% had prior glaucoma surgery. Patients underwent implantation of stents without surgical complications. Mean IOP was 13.8±1.8 mmHg at 3 year (representing a 43% (10.5 mmHg) reduction from preoperative mean IOP), and mean medication use decreased to 0.4 medication from 2.8 preoperatively (86% reduction). At 3 years, 95% of eyes were using zero or 1 medication. Postoperative progression of pre-existing cataract was observed in 2 eyes. At 3 years postop, 95% of eyes had BCVA 20/40 or better.

Conclusions:

In this cohort of patients, substantial and sustained reduction in both IOP and medication use and favorable safety was reported through 3 years postoperative following implantation of 2 iStent inject devices as the solitary surgical procedure in eyes with OAG not controlled by previous medical and/or surgical therapy. A 43% (10.5 mmHg) decrease from preoperative mean IOP and an 86% decrease in medication burden was observed at 3 years with almost all patients on zero or 1 medication at year-3. The iStent inject adds to the surgeon’s armamentarium when treating patients with glaucoma.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a competing company, travel has been funded, fully or partially, by a competing company, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, research is funded, fully or partially, by a competing company, research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented