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Steven David Vold, Michael R McFarland; Retrospective Review of a Suprachoroidal Micro-Stent as a Stand Alone Procedure for the Treatment of Refractory Primary Open Angle Glaucoma: 6-Month Results. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2044.
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Evaluate the efficacy and safety of the CyPass Micro-Stent (Alcon Laboratories, Inc., Fort Worth, TX) for the treatment of primary open angle glaucoma (POAG) refractory to topical medications and surgery. We hypothesize that the CyPass Micro-Stent will reduce mean IOP by ≥ 20% with the same or fewer medications needed postoperatively.
A retrospective chart review was conducted at single private practice, Vold Vision P.L.L.C, between the dates of October 2016 and November 2017. The CyPass Micro-Stent was implanted in patients whose intraocular pressure was inadequately controlled by medical therapy, laser therapy, or incisional surgery. All patients were pseudophakic. Safety data was collected in the form of loss of best-corrected visual acuity (BCVA), IOP changes, slit lamp changes, fundus abnormalities, and adverse events. Generalized linear mixed models were used to analyze data and to account for correlation.
Twenty subjects contributing 26 eyes were available for 6-month analysis. At baseline 77% of eyes were on 3 or more medications with a mean ± standard deviation (SD) baseline IOP of 17.54 mmHg ± 6.91. Prior failed surgeries included 14 selective laser trabeculoplasties (SLT), 5 trabeculectomies, 3 EX-PRESS Shunts (Alcon Laboratories, Inc., Fort Worth, TX), 2 canaloplasties, 1 tube shunt, 1 Trabectome (NeoMedix Tustin, CA, USA), and 1 iStent (Glaukos, Laguna Hills, CA, USA). Approximately 50% of eyes had failed multiple modalities. Following CyPass implantation there were no surgical related complications including choroidal disorders and hypotony maculopathy. Six months postoperatively there was a 4.38 mmHg reduction in IOP (95% confidence interval (CI):1.23,7.53), indicating an average reduction in IOP of 24.7% (p = 0.008). Medication usage had also been reduced by 2.42 (95% CI:1.93,2.19) meds, with 73% of patients requiring no medications at 6 months.
The CyPass Micro-Stent was safe and effective 6 months postoperatively in patients refractory to topical medications, prior laser surgery, and prior incisional surgery.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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