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Abstract #20378 Published in IGR 10-1

Combined cataract-glaucoma surgery using the intracanalicular Eyepass glaucoma implant First clinical results of a prospective pilot study

Dietlein TS; Jordan JF; Schild A; Konen W; Jünemann A; Lüke C; Krieglstein GK
Journal of Cataract and Refractive Surgery 2008; 34: 247-252


PURPOSE: To study prospectively the safety and pressure-reducing efficacy of the Y-shaped Eyepass glaucoma implant (GMP Vision Solutions, Inc.). SETTING: Departments of Ophthalmology, University of Cologne, Cologne, and University of Erlangen, Erlangen, Germany. METHODS: This study comprised 12 patients with primary open-angle or exfoliative glaucoma and cataract who had phacoemulsification with endocapsular implantation of a foldable intraocular lens and intracanalicular implantation of an Eyepass glaucoma implant. The implant is a silicone microtube shunt that bypasses the trabecular meshwork and connects the lumina of Schlemm canal with the anterior chamber in combined cataract-glaucoma surgery. Perioperative complications, intraocular pressure (IOP), and pressure-reducing topical medications were monitored over a preliminary follow-up. RESULTS: Perforation of the trabecular meshwork during Eyepass implantation occurred in 2 eyes; the antiglaucoma procedure was converted to trabeculotomy after the shunt was explanted, and both eyes were excluded from further follow-up. In the remaining 10 eyes, the mean maximum IOP was 30.4 mmHg ± 7.5 (SD) (range 21 to 46 mmHg) preoperatively, 12.0 ± 6.1 mmHg (range 2 to 20 mmHg) 1 day postoperatively, 17.2 ± 4.1 mmHg (range 12 to 27 mmHg) at 4 weeks, and 18.3 ± 4.5 mmHg (range 12 to 25 mmHg) at the end of the preliminary follow-up. The mean number of topical medications was 3.2 ± 0.8 preoperatively and 0.9 ± 0.7 at the end of follow-up (mean 7.1 months). Although there were no major complications requiring surgical revision, 4 eyes had an IOP of 18 or higher at the end of follow-up. CONCLUSION: Combined cataract surgery with Eyepass shunt implantation was safe and appeared to be beneficial in glaucomatous eyes with cataract not requiring a low target IOP.

Dr. T.S. Dietlein, Department of Ophthalmology, University of Cologne, Cologne, 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)



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