Surgical Technique and Outcomes of ICE: MIGS Implantation of Trabecular Bypass Stent, Cataract Surgery, and Endoscopic Cyclophotocoagulation
Narrative Responses:
Purpose
The ICE surgical procedure is defined as implantation of a trabecular micro-bypass stent (iStent), performed in conjunction with cataract extraction and endoscopic cyclophotocoagulation (ECP). The purpose was to assess outcomes following the ICE procedure in eyes with mild-moderate open-angle glaucoma.
Methods
An initial retrospective series included 24 eyes of 20 patients implanted with iStent via the ICE procedure. The iStent (Glaukos), a trabecular micro-bypass stent, was implanted in Schlemm’s canal after cataract surgery along with endoscopic cyclophotocoagulation (ECP).
Results
Twenty eyes underwent uncomplicated implantation of the iStent. Mean preoperative IOP was 19.1 ± 6.3 mmHg on a medication burden of 2.2 ± 1.1 preoperative ocular hypotensive medications. To date, patients have been followed for 69 ± 43.6 days (ranging from 30 to 184 days postoperative). At the most recent follow-up exams, patients’ mean IOP was 15.5 ± 3.9 mmHg on a medication burden of 1.7 ± 1.6 medications. No adverse events were reported.
Conclusion
Implantation of an iStent along with endoscopic cyclophotocoagulation and cataract extraction may be a beneficial combination of procedures. The surgical technique and outcomes following this procedure, with postoperative follow-up through a minimum of six months in a larger series from several surgeons, will be included.