July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Implantation of two second-generation trabecular micro-bypass stents with concomitant cataract surgery in primary angle closure glaucoma: one-year outcome
Author Affiliations & Notes
  • Ali Salimi
    Faculty of Medicine, McGill University, Montreal, Quebec, Canada
  • Paul Harasymowycz
    Ophthalmology, University of Montreal, Quebec, Canada
    Clinique d'ophtalmologie Bellevue, Quebec, Canada
  • Footnotes
    Commercial Relationships   Ali Salimi, None; Paul Harasymowycz, Aerie Pharmaceuticals (S), Alcon Laboratories, Inc (C), Allergan (C), Bausch+Lomb (C), Glaukos Corporation (C), Ivantis (C), Johnson & Johnson Vision (C), Novartis Pharmaceuticals Corporation (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5242. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Ali Salimi, Paul Harasymowycz; Implantation of two second-generation trabecular micro-bypass stents with concomitant cataract surgery in primary angle closure glaucoma: one-year outcome. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5242. doi: https://doi.org/.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : The recent emergence of second-generation trabecular microbypass stents has allowed improved multidirectional flow with good efficacy and safety profile in primary open-angle glaucoma. The efficacy of this new device in primary angle closure glaucoma has been understudied. Thus, we aimed to assess the one-year postoperative outcomes following implantation of two second-generation trabecular micro-bypass stents (iStent inject®) with concomitant cataract surgery in angle-closure glaucoma patients.

Methods : In this retrospective chart review study, we evaluated the baseline clinical characteristics and the 12-month outcomes of patients with mild to severe primary angle-closure glaucoma who underwent implantation of two iStent inject devices with concomitant cataract surgery, at a single ophthalmology clinic. The primary outcomes included intraocular pressure (IOP) and anti-glaucoma medication use. The secondary outcomes were success rate (defined by IOP between 5 and 18 mmHg with IOP reduction of at least 20%), visual acuity, and complications. Changes in IOP, medication burden, and visual acuity were evaluated using repeated measure ANOVA with significance set at p<0.05.

Results : 30 eyes of 19 patients were included with an average age of 66.1±9.3 years. All eyes had mild to severe angle-closure glaucoma. The preoperative IOP decreased by 16% from 16.57±3.99 mmHg to 14.97±2.50 (p=0.010, Eta-squared=0.206), and the average anti-glaucoma medication use dropped by 46% from 2.83 to 1.53 at one-year follow-up (p<0.001, Eta-squared=0.570). The 12-month success rate was 47% (14 out of 30), visual acuity remained stable (p=0.123), and the post-operative complications only included a case of microhyphema and a case of IOP spike, which were both minor and resolved spontaneously.

Conclusions : The present study provides clinically relevant, real-world data on the utility of iStent inject with cataract surgery in angle-closure glaucoma – a population that has been understudied in the world of trabecular micro-bypass stents. Patients experienced meaningful individual-level reductions in medication burden, while their already-low IOP was reduced further. These improvements were sustained for one-year post-operative, and the safety was favorable.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

The lines represent IOP (blue) and medication burden (red), and the bars show standard error of the mean

The lines represent IOP (blue) and medication burden (red), and the bars show standard error of the mean

×
×

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.

×