One-Year Single-Site Experience With Trabecular Bypass Stent and Cataract Surgery in Glaucoma Patients With Prior Medical/ Surgical Therapy

Sunday, April 19, 2015: 1:16 PM
Room 1A (San Diego Convention Center)
Michael C. Stiles, MD

The objective is to report one-year findings of a single surgeon's experience with implantation of a trabecular micro-bypass stent during cataract surgery in a series of glaucoma patients previously treated with medical and/or surgical therapy.

Ongoing interventional case series involving 50 patients with glaucoma with prior medical and/or surgical therapy who underwent implantation of one iStent and cataract surgery.   At present, 35 eyes have been followed through a 1-year postoperative period.   Descriptive statistics include demographics and preoperative characteristics, target intraocular pressure (IOP), and postoperative parameters of IOP, medication use, best corrected visual acuity (BCVA), CD ratio, pachymetry, visual field, complications and secondary surgeries through 1 year.

This series consisted of 19 males and 31 females, with mean age 68.3 (SD 8.0) years, mean IOP 18.6 (SD 4.6) mmHg, CD ratio 0.7 (SD 0.1), visual field-mean deviation of -5.2 (SD 6.6) dB; 61% had BCVA 20/40 or better.   Fifty percent of subjects were taking 2 or more medications, and 38% had undergone prior glaucoma surgery.  Complications after the perioperative period through 1 year included blepharitis (n=2) and dry eye (n=1).  No eyes required secondary surgeries.  At 1 year, 83% had BCVA 20/40 or better (68% 20/25 or better).   Mean IOP at 1 year was 15.2 (SD 2.4) mmHg, with 63% of eyes on 0 medications and 26%, 9% and 3% on 1,2 and 3 medications, respectively.

A single-surgeon series of glaucoma patients with prior medical/surgical therapy who received stents during cataract surgery had a 19% reduction in mean IOP and 68% reduction in mean medication use, with a complication rate well within that expected post-cataract surgery.   This procedure was shown to be an effective and safe option for these patients.