May 09, 2016
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The iStent inject maintains IOP reduction at 18 months

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NEW ORLEANS — A second-generation trabecular micro-bypass stent significantly reduced IOP with no intraoperative complications, according to a study presented here.

At the American Society of Cataract and Refractive Surgery meeting, Richard L. Lindstrom, MD, reported 18-month results obtained with the iStent inject trabecular micro-bypass stent (Glaukos) implanted in patients with mild to moderate glaucoma that was well controlled on a single medication.

Richard L. Lindstrom

The iStent inject was implanted in patients in Armenia; the device is not approved by the FDA, Lindstrom said.

“It is much easier to do, in my opinion, than the first-generation iStent. But it’s also a trabecular micro-bypass system. In all of these patients we actually place two stents rather than a single stent, which is currently approved in the U.S.,” Lindstrom said.

The study included 57 eyes of 57 patients with a mean age of 65.3 years. Mean number of medications was one. Mean medicated IOP was 19.5 mm Hg; mean unmedicated IOP was 24.4 mm Hg. The procedure was not done in combination with cataract surgery.

Twelve-month results showed that IOP decreased more than 20% from preoperative unmedicated IOP in 100% of patients and more than 20% from preoperative medicated IOP in 75% of patients.

Mean unmedicated IOP at 12 months was less than 18 mm Hg in all patients and less than 15 mm Hg in 67% of patients.

Mean IOP was 24.4 mm Hg at baseline, 14.3 mm Hg at 1 month, 14.2 mm Hg at 3 months and 14.4 mm Hg at 18 months, Lindstrom said.

No intraoperative or postoperative complications were reported. Best corrected visual acuity deceased in one patient with progressive cataract.

BCVA was 20/40 or better in 93% of patients at 18 months.

“I think that suggests that the second-generation iStent and trabecular bypass procedure may be quite an effective operation for us and that it can work not in combination with cataract surgery, and it worked in both phakic and pseudophakic eyes,” Lindstrom said. – by Matt Hasson and Patricia Nale, ELS

Reference:

Lindstrom RL. Use of second generation trabecular stents as sole procedure in eyes with open angle glaucoma on one preoperative medication: 18-month report. Presented at: American Society of Cataract and Refractive Surgery meeting; May 6-10, 2016; New Orleans.

Disclosure: Lindstrom reports he is a consultant for AqueSys, Glaukos and Transcend Medical.