The implantation of a single trabecular microbypass stent provided stable, long-term IOP and medication reduction in a real-life cohort of eyes with a variety of glaucoma types and severity.
Sixty-five eyes of 43 patients with open-angle glaucoma and a mean age of 72.7 + 7.7 years were successfully and uneventfully implanted with the iStent (Glaukos Corp.) microbypass by a single surgeon in a private eye clinic in Munich, Germany.
Diagnoses included primary open-angle glaucoma, pseudoexfoliation glaucoma, secondary uveitic glaucoma, posttraumatic glaucoma as well as ocular hypertension. The degree of severity and optic nerve damage varied, with a predominance of more advanced cases. More than one-third of the eyes had previously undergone trabeculectomy or laser procedures, and more than two-thirds were on two or more medications. All eyes had visually significant cataract, and iStent implantation was combined with cataract surgery.
The long-term, 5-year follow-up showed stable decrease of IOP by 38% on average, with 92% of the eyes achieving an IOP of 18 mm Hg or lower, and 65% achieving an IOP of 15 mm Hg or lower. Medications were reduced by 75% to 0.5 vs. 2.0 preoperatively. The number of eyes on three to four medications decreased to 4% at 5 years vs. 28% preoperatively, and 69% of the patients became medication-free, “eliminating the cost, time and side effects associated with medication use,” the authors noted.
Over the duration of the follow-up, no severe device-related adverse event occurred.
This study provides some of the longest follow-up data currently published in the literature and proves the long-term efficacy and safety of the iStent implant in a heterogeneous patient population in a real-life clinical setting, the authors said.
“This realistic scenario makes the outcomes particularly relevant to practicing ophthalmologists who are evaluating surgical treatment options for their glaucoma patient population,” the authors wrote. – by Michela Cimberle
Disclosures: Neuhann conducts paid presentations for Staar Surgical Co. and Bausch + Lomb. Publication fees were paid by Glaukos Corp.