Abstract
Purpose :
Minimally invasive (or micro-invasive) glaucoma surgeries (MIGS) have emerged over the last several years as a promising method for decreasing intraocular pressure while simultaneously decreasing medication burden. Our purpose was to evaluate the effectiveness of two different MIGS procedures, Cypass and iStent, for surgical treatment of primary-open angle glaucoma when implanted in conjunction with cataract surgery.
Methods :
In a retrospective analysis, data from patients undergoing combined cataract surgery and MIGS with either Cypass or iStent from 2015 to 2018 were analyzed. Preoperative and postoperative data through the last follow-up visit were collected. The main outcome measures included IOP reduction from preoperative baseline and reduction in IOP-lowering medication use.
Results :
Data were collected from 269 eyes from 214 subjects. Mean age at surgery was 71.2 years, and 59.3% of the subjects were female. Of the 269 eyes, 61 received implantation with Cypass and 208 received implantation with iStent. Mean preoperative IOP in the Cypass group was 18.0 ± 6.8 mmHg compared to 15.7 ± 3.8 mmHg in the iStent group. Only 42 eyes (69%) in the Cypass group completed at least 6 months of postoperative follow-up, compared to 133 eyes (64%) in the iStent group. Mean IOP reduction at 6 months postoperative was 2.6 mmHg for the Cypass group (14% reduction) versus 0.9 mmHg in the iStent group (6% reduction). Mean preoperative medication use per eye was 1.6 ± 1.0 in the Cypass group and 1.4 ± 1.0 in the iStent group compared to 0.6 ± 0.9 in the Cypass group and 0.5 ± 0.8 in the iStent group, respectively, at 6 months postoperative. Of the patients in the Cypass group, 64% did not require medications at 6 months follow up (15% at baseline), compared to 60% in the iStent group (6% at baseline).
Conclusions :
Implantation of either Cypass or iStent, in conjunction with cataract surgery, were both associated with a moderately sustained reduction in IOP as well as a reduction in the number of IOP-lowering medications. Although both MIGS procedures resulted in a similar decrease in number medications used, total IOP reduction was favored in the Cypass group.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.