May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Safety and Efficacy of the Trabecular Bypass Micro Stent in Secondary Glaucoma
Author Affiliations & Notes
  • O. Buchacra
    Glaucoma, Instituto Condal de Oftalmologia/USP Instituto Universitario Dexeus, Barcelona, Spain
  • S. Duch
    Glaucoma, Instituto Condal de Oftalmologia/USP Instituto Universitario Dexeus, Barcelona, Spain
  • E. Millà
    Glaucoma, Instituto Condal de Oftalmologia/USP Instituto Universitario Dexeus, Barcelona, Spain
  • D. Andreu
    Glaucoma, Instituto Condal de Oftalmologia/USP Instituto Universitario Dexeus, Barcelona, Spain
  • J. Tellez
    Glaucoma, Instituto Condal de Oftalmologia, Barcelona, Spain
  • Footnotes
    Commercial Relationships  O. Buchacra, None; S. Duch, None; E. Millà, None; D. Andreu, None; J. Tellez, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 4178. doi:
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    • Get Citation

      O. Buchacra, S. Duch, E. Millà, D. Andreu, J. Tellez; Safety and Efficacy of the Trabecular Bypass Micro Stent in Secondary Glaucoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4178.

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

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Abstract

Purpose: : The physiopathology of secondary glaucoma is based on the decrease of aqueous flow because there is a reduction of permeability on the trabecular meshwork. The iStent increases the trabecular outflow bypassing the trabecular meshwork. This study was undertaken to evaluate the safety and efficacy of the iStent reducing IOP in secondary glaucoma subjects.

Methods: : Prospective, non-randomized, open-labeled study. 10 eyes with secondary glaucoma, 4 with traumatic glaucoma, 4 with cortisonic glaucoma, 1 with pigmentary glaucoma and 1 with pseudoexfoliative glaucoma. All patients were scheduled for surgery under topical anesthesia and trough a clear cornea paracentesis a iStent was placed in the Shlemm's canal. Nº of antiglaucoma medications (AM), complications, IOP and gonioscopy were assessed before and after surgery at 1, 7, 15, 30 days, 3, 6 and 12 months. One eye required trabeculectomy + MMC at 6 months, and 1 eye was lost to follow-up at 3 months. Those results were included in this analysis.

Results: : The mean follow-up period was 9.72 ± 4.81 months. The mean preoperative IOP was 26.30 ± 8.16 mmHg with 3.00 ± 0.66 AM. On the first day the mean IOP was 20.60 mmHg ± 17.4 with 0.90 ± 1.44 AM,17.40 mmHg ± 4.45 with 0.88 ± 1.53 AM at 7 days, 19.60 mmHg ± 8.84 with 1.00 ± 1.22 AM at 15 days, 17.40 mmHg ± 4.92 with 1.80 ± 1.22 AM at 1st month, 16.10 mmHg ± 3.87 with 2.00 ± 1.33 AM at 3 months, 18.00 mmHg ± 4.60 with 1.88 ± 1.05 AM at 6 months, 17.50 mmHg ± 3.20 with 1.66 ± 1.03 AM at 12 months. By 12 months, the mean number of medications was reduced from 3.00 ± 0.66 to 1.66 ± 1.03. 80% of patients IOP was ≤ 20 mmHg having reduced at least 1 hipotensive medication on the last follow up. Early postoperative complications were clinically mild and included: hiphema: 7 cases (70%), postoperative ocular hypertension: 4 cases (40%), corneal edema: 2 cases (20%), stent lumen obstruction: 2 cases (20%), stent malposition: 1 case (10%), that was reinserted. 1 eye required Trabeculectomy + MMC because with maximum medication had not controlled IOP at 6 months. 1 case was lost to follow-up at 3 months.

Conclusions: : Glaukos iStent® is a trabecular bypass that resulted in good IOP control by increasing the trabecular outflow facility. This surgery, reduced the Nº of antiglaucoma medications controlling IOP with minimal complications. Longer follow up is needed to assess the long-term hypotensive efficacy in secondary glaucoma.

Keywords: clinical (human) or epidemiologic studies: systems/equipment/techniques 
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