Surgical Technique and Outcomes of ICE: MIGS Implantation of Trabecular Bypass Stent, Cataract Surgery, and Endoscopic Cyclophotocoagulation

Saturday, April 26, 2014: 3:36 PM
Room 154 (Boston Convention and Exhibition Center)
Nathan M. Radcliffe, MD, Weill Cornell Medical College, New York, NY, USA
Kristin Chapman, MD, Weill Cornell Medical College, New York, NY, USA
Robert J. Noecker, MD, MBA, Ophthalmic Consultants of Connecticut, Fairfield, CT, USA
Parag Parekh, MD, MPA, Laurel Eye Clinic, Brookville, PA, USA

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.