Trabectome may yield advantage in early postop period
When combined with cataract surgery, both Trabectome and a single Glaukos iStent reduce IOP and medication burden in glaucoma patients, but Trabectome may yield better results in the early postoperative period, according to a study.
The study, a retrospective interventional case series, included 45 patients with bilateral visually significant cataract and open-angle glaucoma. Patients were evaluated following same-surgeon surgery in which phacoemulsification with Trabectome was used in one eye and phacoemulsification with iStent was used in the contralateral eye.
In the early postoperative period at 3 to 4 hours, IOP was elevated in 12 eyes in the Trabectome group and 13 eyes in the iStent group. However, the mean elevation was statistically significantly less in the Trabectome group, 4.3 mm Hg vs. 8.7 mm Hg (P = .048). Mean change in IOP at 20 to 24 hours postoperatively compared with baseline was greater in the Trabectome group compared with the iStent group, -2.7 mm Hg vs. -1.4 mm Hg.
In longer follow-up, at 1, 6, 12 and 24 months, both procedures yielded similar IOP lowering and medication reducing results.
“Minimally invasive glaucoma surgery procedures are effective, with a relatively low-risk profile, in reducing IOP and IOP-lowering medication burden in glaucomatous eyes. However, all MIGS are not the same, and some are far more expensive to our health system than others,” Asher Weiner, MD, study co-author, told Healio/OSN. “This study demonstrates that unroofing Schlemm's canal using the Trabectome is as effective and probably safer than implanting a 3-fold more expensive stent to increase the drainage out of the eye.”
The study was limited by its retrospective design and because 43 of the 45 patients were white.
“Thus, our results may not necessarily apply to all ethnic groups and a future large prospective study may provide data comparing the outcomes of different MIGS procedures in different ethnic groups,” the authors said.