Ab Interno Gelatin Stent With Mitomycin-C Combined With Cataract Surgery for Treatment of Open-Angle Glaucoma: 1-Year Results

Saturday, April 18, 2015: 3:01 PM
Room 1B (San Diego Convention Center)
Arsham Sheybani, MD
Ike K. Ahmed, MD

Purpose
To evaluate the intraocular pressure (IOP) lowering effects of an ab-interno gelatin stent in combination with cataract surgery and mitomycin C (MMC) in patients with open angle glaucoma.

Methods
This was a prospective, non-randomized, multi-center study.  Patients with open angle glaucoma requiring surgical treatment for glaucoma and cataract underwent implantation of the XEN 45 with MMC combined with phacoemulsification. Primary outcome measures were IOP and number of medications. Secondary outcome measures were visual acuity and post-operative interventions and complications.  Complete success was defined as a postoperative IOP < 18 mmHg with > 20% reduction in IOP at 12 months without any glaucoma medications. Failure defined as vision loss of light perceptions vision or worse, need for additional glaucoma surgery, or < 20% reduction of IOP from baseline.

Results
Thirty-one eyes were included in the study. The mean preoperative IOP was 20.8 + 4.6 mmHg. The mean postoperative IOP’s were: 14.4 + 4.9 mmHg at 6 months and 13.1 + 3.6mmHg  at 12 months (p<0.001). Mean number of preoperative medications was 2.7 + 1. Number of medications at 12 months was reduced to 0.9 + 1.1 (p<0.001). There were no complications.

Conclusion
The XEN 45 gelatin stent implanted with adjuvant MMC at the time of cataract surgery lowered IOP and decreased the number of medications in patients with open angle glaucoma and cataract.