Evaluation of Trabecular Micro-Bypass Stent With Phacoemulsification in Patients With Open-Angle Glaucoma and Cataract

Sunday, April 19, 2015: 2:11 PM
Room 1A (San Diego Convention Center)
John P. Berdahl, MD
Tanner J. Ferguson
Justin A. Schweitzer, OD

Purpose
To evaluate the safety and efficacy of the iStent Trabecular Micro-Bypass stent in combination with cataract surgery in patients with open-angle glaucoma.

Methods
The series was comprised of 200 eyes with open-angle glaucoma. Data was collected pre-operatively, and postoperative data was collected at 1 day, 1 week, 1 month, 3 months, 6 months and 1 year, 18 months and 2 years. Data included intraocular pressure (IOP), number of glaucoma medications, visual acuity (VA), the incidence of post-operative IOP pressure spikes of greater than ≥15mmHg at any time point, and need for additional surgery.

Results
The mean pre-operative IOP was 18.48 ± 6.40 mmHg. At 18 months postoperative, mean IOP was 14.90 ± 3.64 mmHg (p<0.001).  The mean number of glaucoma medications was 1.27 ± 1.01 pre-operatively and 0.69 ± 1.06 (p<0.001) at 1 year postoperative.  At 1-day post-operative, 30 eyes (15%) experienced an IOP increase of 15mmHg above their baseline IOP that responded to topical therapy. 1 patient required additional surgery and was implanted with an Ahmed Tube Shunt postoperatively.

Conclusion
The insertion of the iStent Trabecular Micro-Bypass stent in combination with cataract surgery effectively lowers IOP in open-angle glaucoma patients.  Medication use was significantly reduced postoperatively.  The safety profile appears favorable with a low rate of IOP spikes and only 1 patient requiring additional surgery.