Combined Use of ab Interno Trabecular Micro-Bypass Stent With Femtosecond Laser–Assisted Cataract Surgery in Patients With Glaucoma and Cataracts

Sunday, April 19, 2015: 1:46 PM
Room 1A (San Diego Convention Center)
Robert J. Noecker, MD, MBA

To determine the efficacy and safety of combined femto-laser assisted cataract surgery and the istent in treating patients with co-existing cataracts and glaucoma.

A retrospective case series of 30 combined femto-laser assisted cataract surgeries and istent trabecular microbypass devices was evaluated. Consecutive patients with at one least one year of follow-up were included in the series.  Inclusion criteria were diagnosis of visually significant cataract and mild to moderate glaucoma with the active use of at least one glaucoma medication. The primary endpoint measure was IOP at one year. Secondary measures were refractive error, visual acuity, complications, post-operative inflammation and use of post-operative medications.

Patients who underwent combined femto-laser assisted cataract surgery combined with istent had a significant reduction in IOP from baseline (mean IOP reduction= 4.6 mm Hg, p= 0.03).  Mean reduction in glaucoma medications was 0.5 medications.  The use of the istent appeared to have no impact on predicted refractive outcome of the cataract surgery.   No patients exhibited a need for more prolonged use of anti-inflammatory medications beyond the usual post-operative regimen used for cataract surgery.

The combined use of femto-laser assisted cataract surgery and istent appears to be an effective and safe method of treating cataract and glaucoma.   The impact of the istent on refractive outcome of the cataract surgery appears to be minimal.