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PURPOSE OF THE STUDY: The purpose of the study was to evaluate the safety and efficacy of the iStent Trabecular Micro-Bypass stent in pseudophakic patients with open-angle glaucoma. METHODS: Retrospective, consecutive case series from October 2012 to May 2015 with no exclusion criteria. The series comprised 42 pseudophakic eyes with open-angle glaucoma that were implanted with 1 iStent. Data were collected preoperatively, and postoperative data were collected at 1 day, 1 week, 1, 3 and 6 months, 1 year, 18 months and 2 years. Data included intraocular pressure (IOP), number of glaucoma medications, the incidence of postoperative IOP pressure spikes ≥15 mm Hg at any timepoint, and the need for additional surgery. RESULTS: The mean preoperative IOP was 20.26±6.00 mm Hg. At 1 year postoperatively, the mean IOP was 16.34±3.78 mm Hg (P<0.01). At 2 years postoperatively, the mean IOP was 13.62±4.55 (P<0.01). The mean number of glaucoma medications was 1.95±1.01 preoperative and 1.69±1.28 (P>0.05) at 1 year postoperatively. Postoperatively, 3 eyes (7%) experienced an IOP increase of 15 mm Hg above their baseline IOP that responded to topical therapy. In total, 96% of patients with an IOP≥19 mm Hg achieved a reduction in IOP at their last collected follow-up. CONCLUSIONS: The insertion of the iStent Trabecular Micro-Bypass stent effectively lowers IOP in pseudophakic patients with open-angle glaucoma. Although medication use was not significantly reduced postoperatively at 1 year, 80% of patients either experienced a reduction or no change in medication use. The safety profile appears favorable with a low rate of IOP spikes and only 1 patient requiring additional surgery.
*University of South Dakota Sanford School of Medicine ‡Master of Public Health Program, School of Health Sciences, University of South Dakota †Vance Thompson Vision, Sioux Falls, SD.
Full article9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)