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Abstract #46120 Published in IGR 13-2
One-year analysis of the istent trabecular microbypass in secondary glaucoma
Buchacra O; Duch S; Milla E; Stirbu OClinical Ophthalmology 2011; 5: 321-326
Purpose: To evaluate the midterm efficacy and safety of the iStent(registered trademark) glaucoma device in patients with secondary open-angle glaucoma. Patients and methods: A prospective, nonrandomized, interventional case series involving 10 patients with secondary open-angle glaucoma (traumatic, steroid, pseudoexfoliative, and pigmentary glaucoma) of recent onset who underwent ab interno implantation iStent. Patients were assessed following the procedure on days 1, 7, and 15 and months 1, 3, 6, and 12, and examinations included visual acuity, intraocular pressure (IOP) measurement using Goldmann tonometry, number of glaucoma medications, and complications. Wilcoxon rank-test for data with abnormal distribution was used for the analysis of IOP and glaucoma medications at baseline versus 3, 6, and 12 months following the procedure. Results: The mean baseline IOP was 26.5 (plus or minus) 7.9 (range 18-40) mmHg, and significantly decreased in 10.4 (plus or minus) 9.2 mmHg at three months (P <0.05), in 7.4 (plus or minus) 4.9 mmHg at six months (P < 0.05), and in 6.6 (plus or minus) 5.4 mmHg at 12 months (P< 0.05) following iStent implantation. The mean number of hypotensive medications at baseline was 2.9 (plus or minus) 0.7 (range 2-4). Statistically significant reductions in the number of medications of 1.1 (plus or minus) 1.1 were observed at three months (P < 0.05), 1.0 (plus or minus) 0.7 at six months (P< 0.05), and 1.1 (plus or minus) 0.6 at 12 months (P< 0.05). No significant changes in visual acuity were noted. The most common complications comprised mild hyphema in seven eyes and transient IOP $30 mmHg in three eyes on postoperative day 1. Obstruction of the lumen of the stent with a blood clot was seen in three eyes, and all instances resolved spontaneously. Conclusion: The iStent is a safe and effective treatment option in patients with secondary openangle glaucoma, and reduces the topical treatment burden in one hypotensive medication.
S. Duch. Calatrava 10-12, 5,2, 08017 Barcelona, Spain. Email: sduch@icoftalmologia.es
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.4.3.1 Pigmentary glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.3 Glaucomas associated with disorders of the iris and ciliary body)
9.4.4.1 Exfoliation syndrome (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
9.4.1 Steroid-induced glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
