Minimally Invasive Drainage Implant: 3-Year Follow-up
Narrative Responses:
Purpose
To report the experience of the minimally invasive drainage implant (InnFocus-MIDI Arrow) in patients with glaucoma. The purpose of this study is to evaluate the IOP lowering effects of the microshunt used either alone or in combination with phacoemulsification for a period of three years.
Methods
Twenty-one eyes included; 8 eyes underwent combined glaucoma and phacoemulsification surgery and 13 eyes had glaucoma procedures alone. All eyes received an intraoperative wide application under the subconjunctival flap of 0.4 mg/mL of Mitomycin C for three minutes. The flexible tube made of the biocompatible material SIBS was implanted through a 3 mm long needle track made with a 27 g needle.
Results
The average medicated baseline IOP was 23.9 ± 5.4 mmHg (n=21). The average IOP dropped 56% to 10.6 ± 2.8 mmHg (n=21) and 52% to 11.4 ± 3.0 mmHg (n=17) at 1 and 2 years, respectively. The success rate, measured by dropping IOP by ≥20% without surgical intervention, was 100% (21/21) and 94% (16/17) at 1 and 2-years, respectively. There were two cases of transient hypotony and two choroidal effusions which cleared spontaneously. There were no long-term sight-threatening adverse events.
Conclusion
The InnFocus MicroShunt effectively lowered IOP by 56% and 52% with 90% and 88% of patients achieving IOP of ≤ 14 mmHg at one and two years, respectively without serious long-term adverse events. The simplicity of use and ease of follow-up will provide a simple and effective replacement for trabeculectomy.