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Abstract #22874 Published in IGR 11-1
Coexistent primary open-angle glaucoma and cataract: preliminary analysis of treatment by cataract surgery and the iStent trabecular micro-bypass stent
Spiegel D; Garcia-Feijoo J; Garcia-Sanchez J; Lamielle HAdvances in Therapy 2008; 25: 453-464
INTRODUCTION: Reducing intraocular pressure (IOP) is the only proven treatment modality for reducing the risk of glaucomatous progression. In this study, we evaluated the safety and efficacy of a new tool in IOP reduction, implanted with cataract surgery: the Glaukos iStent trabecular micro-bypass stent. METHODS: This was a prospective, 24-month, uncontrolled, non-randomised, multicentre study. Subjects with uncontrolled primary open-angle glaucoma (including pseudoexfoliation and pigmentary) and a cataract underwent clear cornea phacoemulsification cataract extraction with ab-interno gonioscopically guided implantation of the study stent. Subjects who had completed at least 6 months of follow-up were included in this interim analysis (n=47). RESULTS: At baseline, mean (±standard deviation) IOP was 21.5±3.7 mmHg, and subjects were taking a mean of 1.5±0.7 ocular hypotensive medications. Six months after implantation of the study stent the mean IOP was 15.8± 3.0 mmHg, a mean IOP reduction of 5.7±3.8 mmHg (25.4%, P<0.001). The mean number of patient medications after 6 months was 0.5±0.8 medications, a mean decrease of 1.0±0.8 medications (66.7%, P<0.001). Most subjects (70%) were able to discontinue all glaucoma medications. There were no complications traditionally associated with filtering surgery, and no serious adverse events were reported. CONCLUSION: In this interim analysis of subjects with glaucoma and cataracts, this novel stent implantation in subjects undergoing cataract surgery represents a new surgical approach to provide clinically significant decreases in IOP and drug burden.
Dr. D. Spiegel, Klinik Vincetinum, Augsberg, Germany
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
