December 13, 2019
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Endothelial cell loss continues at least 5 years after CyPass implantation

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In eyes with open-angle glaucoma, endothelial cell loss after phacoemulsification combined with CyPass implantation continued for at least 5 years, while endothelial cell loss stabilized in eyes that underwent phaco without CyPass implantation after 3 months, according to a study.

“The study demonstrated the importance of long-term follow-up of MIGS devices, specifically CyPass, given no difference in cell loss was noted between the cataract surgery-alone group and the CyPass/cataract surgery group 2 years postop, while at 5 years there was twice the cell loss, 20% vs. 10%, in the CyPass group,” study co-author Jonathan H. Lass, MD, told Healio/OSN.

Researchers evaluated long-term changes in corneal endothelial cell loss in eyes with open-angle glaucoma after phacoemulsification with or without supraciliary CyPass (Alcon) implantation using data from the COMPASS and COMPASS XT trials. Two hundred fourteen eyes that underwent CyPass implantation plus phacoemulsification were compared with 67 eyes that underwent phacoemulsification alone (control group).

At baseline, eyes in the CyPass cohort had endothelial cell density (ECD) of 2,432.6 cells/mm², while eyes in the control group had ECD of 2,434.5 cells/mm². In the control group, 8% of endothelial cell loss occurred at 3 months postoperatively and remained stable from month 3 to month 60. The ECD in the two groups overlapped until month 48, when ECD decreased in the CyPass group to 1,992.9 cells/mm² compared with 2,303.2 cells/mm² in the control group. The mean ECD in the CyPass group was also lower at month 60, 1,931.2 cells/mm² vs. 2,189.1 cells/mm² in the control group.

“Fortunately, this cell loss was not associated with any serious device-related adverse events. The origin of the greater cell loss in the CyPass group may relate to positioning or movement of the device and requires further study,” Lass said. – by Robert Linnehan

Disclosures: The authors report no relevant financial disclosures.