Posters

Evaluation of MIGS with trabecular micro-bypass stents during cataract surgery in one of the largest cohort of single-surgeon reports

Poster Details

First Author: E.Liang USA

Co Author(s):                        

Abstract Details

Purpose:

To report the author’s individual experience of cataract surgery with trabecular micro-bypass stents (iStent®) in patients with concomitant cataract and OAG. The study further aims to examine the effect of implanting stents in right eyes (slightly supero-nasally positioned) vs. in left eyes (slightly infero-nasally positioned).

Setting:

Private ophthalmology practice in Las Vegas, NV, USA.

Methods:

A single iStent was implanted during cataract surgery in a consecutive series of 861 patients diagnosed with cataract and OAG. Of these, 437 were right-eye surgeries and 424 cases were left-eye. Follow-up through 1 year has been completed in a large subset of patients with 136 patients in the right-eye group and 125 in the left-eye group, with follow-up continuing in all cases. Preoperative and postoperative intraocular pressure (IOP) and topical ocular hypotensive medication use is assessed. Preoperatively, the mean IOP in right eyes was 16.79 mmHg on 1.35 medications, and in left eyes was 16.86 mmHg on 1.17 medications.

Results:

At 1 year postoperative, mean IOP in the right-eye group was 14.06 mmHg (on 1.07 medications); and in the left-eye group was 14.04 mmHg (on 0.98 medications). Outcomes were similar based on analysis of eyes that have reached the 2-year postoperative mark. This represents about 16-17% IOP reduction in either eye sustained out to 2 years postoperative. Overall clinical parameters and outcomes do not appear different for right-eye versus left-eye cases. The safety profile was favorable and comparable to cataract surgery alone. Follow-up will continue such that a larger consistent cohort of eyes with longer-term outcomes will be reported.

Conclusions:

In this series of patients who underwent implantation of iStent during cataract surgery, outcomes at 12 months postoperative exhibited ~17-18% IOP reduction with an improvement in medication burden. Similar outcomes were observed out to 2 years postoperative demonstrating sustained IOP reduction. Results to date appear similar for right vs. left eye cases, hence, stent positioning may not be as important as simply placing stents in the pigmented trabecular meshwork. A favorable safety profile was observed.

Financial Disclosure:

None