Open-Angle Glaucoma in Phakic or Pseudophakic OAG Subjects Treated With Ab Interno Suprachoroidal Stent and Postoperative Travoprost

Auffarth, Gerd

Open-Angle Glaucoma in Phakic or Pseudophakic OAG Subjects Treated With Ab Interno Suprachoroidal Stent and Postoperative Travoprost

Sunday, April 27, 2014: 1:24 PM

Room 155 (Boston Convention and Exhibition Center)

Gerd U. Auffarth, MD, David J Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre, University of Heidelberg, Heidelberg, Germany

Florian T. Kretz, MD, University Ophthalmology Hospital, Heidelberg, Germany

Narrative Responses:

Purpose
A prospective study by the micro-invasive glaucoma surgery (MIGS) study group assessed safety, intraocular pressure (IOP) and medication reduction through 18 months outcomes after implantation of a suprachoroidal stent and postoperative Travoprost in phakic or pseudophakic open-angle glaucoma (OAG) subjects with IOP not controlled on two topical hypotensive medications.

Methods
A suprachoroidal stent (iStent supra^®), designed for ab interno implantation into the suprachoroidal space was implanted through a 1 mm temporal clear corneal incision under topical anesthesia in 80 eyes with moderate to advanced OAG, and with preoperative IOP between 18 mmHg and 30 mmHg on two medications. After medication washout preoperative IOP was required to be between 22 mmHg and 38 mmHg. Following surgery, travoprost was prescribed postoperatively. Subject follow-up is ongoing through five years.

Results
73 subjects underwent uncomplicated stent implantation. Preoperative mean IOP was 20.4 ± 2.4 mmHg on two medications and 24.8 ± 1.7 mmHg after medication washout. At 12 months, 98% of eyes met the primary efficacy endpoint of M12 IOP reduction ≥ 20% vs. preoperative IOP with reduction of one medication; all eyes met the secondary endpoint of M12 IOP ≤ 18 mmHg. Following a 1-month medication washout, mean M13 IOP was 16.7 ± 2.3 mmHg, and subjects restarted medication. In 32 eyes followed through 18 months, mean M18 IOP was 12.3 ± 2.4 mmHg.

Conclusion
Data through 18 months following MIGS implantation of a suprachoroidal stent in phakic or pseudophakic OAG subjects previously uncontrolled on two topical hypotensive medications showed excellent safety and significant reduction in IOP and medication burden.