June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Retrospective analysis of resident-performed microinvasive glaucoma surgery with the iStent
Author Affiliations & Notes
  • Wade Reardon
    Ophthalmology, Medical University of South Carolina, Charleston, SC
  • Robert Allan Sharpe
    Ophthalmology, Medical University of South Carolina, Charleston, SC
  • Elizabeth Sharpe
    Ophthalmology, Medical University of South Carolina, Charleston, SC
    Ophthalmology, Ralph H Johnson VA Medical Center, Charleston, SC
  • Footnotes
    Commercial Relationships Wade Reardon, None; Robert Sharpe, None; Elizabeth Sharpe, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 2694. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Wade Reardon, Robert Allan Sharpe, Elizabeth Sharpe; Retrospective analysis of resident-performed microinvasive glaucoma surgery with the iStent. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2694.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

Microinvasive glaucoma surgery (MIGS) is a burgeoning field with no available data to date regarding outcomes when performed by residents in training. In a retrospective, observational fashion, we evaluated early efficacy and safety outcomes of resident-performed MIGS using the iStent in a veteran population.

 
Methods
 

Data were collected through a retrospective chart review at a Veterans Affairs Medical Center (VAMC) since the iStent became locally available in 2014. Patients were included who underwent combined cataract extraction and placement of an iStent by an ophthalmology resident in his/her 3rd year of training under the supervision of a single, fellowship-trained glaucoma surgeon. Baseline parameters were obtained, including demographics, intraocular pressure (IOP), number of ocular antihypertensive medications (meds), cup-to-disc (C:D) ratio, and best corrected logMAR visual acuity (BCVA). Mean age at surgery was 72.4 ± 8.6 years. Measurements were evaluated postoperatively at 1 day, 1 week, and 1 month. In addition, intraoperative and post-operative complications were recorded.

 
Results
 

Of 25 iStents placed by residents in 2014 at the VAMC, 24 eyes in 19 patients were included. One was excluded due to failure to place the device. Preoperatively, mean IOP was 18.0 ± 4.9 mmHg (range: 11-32). IOP averaged 19.6 ± 6.8 (n = 24) and 19.0 ± 4.9 (n = 17) mmHg at 1 day and 1 week, respectively. By 1 month, mean IOP was 16.8 ± 3.6 mmHg (range: 11-25) (n = 22), representing a 6.7% reduction in IOP from baseline (P = 0.32). Baseline C:D ratio was 0.65 ± 0.16. BCVA improved from 0.45 ± 0.39 to 0.07 ± 0.11 by 1 month (P = 0.02). Number of meds was not statistically different at 1 month (P = 0.81). There were no intraoperative complications associated with the iStent. Within the first week, 5 eyes developed a microhyphema within the first week, which all resolved without intervention.

 
Conclusions
 

When performed by senior ophthalmology residents, MIGS, when combined with cataract surgery, impose minimal risk to patients and produce modest early reductions in IOP in a veteran population. These data may aid with counseling patients preoperatively for resident-performed iStent implantation.

 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×