June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Comparison of iStent Inject, Hydrus Microstent, and Kahook Dual Blade in a Predominately Hispanic Population with Primary Open Angle Glaucoma
Author Affiliations & Notes
  • Hayley Favre
    Ophthalmology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
  • Emily Sherry
    Ophthalmology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
  • Alexander Foster
    Ophthalmology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
  • Corey Waldman
    Ophthalmology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
  • Footnotes
    Commercial Relationships   Hayley Favre, None; Emily Sherry, None; Alexander Foster, None; Corey Waldman, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 3405. doi:
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    • Get Citation

      Hayley Favre, Emily Sherry, Alexander Foster, Corey Waldman; Comparison of iStent Inject, Hydrus Microstent, and Kahook Dual Blade in a Predominately Hispanic Population with Primary Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3405.

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

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Abstract

Purpose : The goal of this study is to compare the outcomes of selected microinvasive glaucoma surgery (MIGS) devices in combination with cataract surgery.

Methods : This is a retrospective chart review of 93 eyes of 79 patients with mild to moderate primary open angle glaucoma (POAG) who underwent a combination of cataract surgery with either iStent inject (n=38), Hydrus microstent (n=24), or Kahook dual blade goniotomy (KDB) (n=31) by one surgeon. Inclusion criteria were no prior surgical intervention for POAG, no laser procedures within 2 years, mild to moderate POAG, and at least 6 months post-op (POM6) follow-up. Statistical analysis was performed using the Kruskall Wallis test.

Results : The percent of intraocular pressure (IOP) reduction at POM6 for iStent inject, Hydrus, and KDB were 10.55%, 4.24%, and 7.74% respectively, but there was no significant difference between the groups (p=0.75). There was a significant difference in the number of medications at both pre-op (p=0.046) and POM6 (p=0.03). The average pre-op number for iStent inject, Hydrus, and KDB were 1.27, 1.67, and 1.81 respectively. At POM6, Hydrus remained at the same average at 1.67 drops, while iStent inject decreased to 0.5 and KDB to 1.29. LogMAR visual acuity improved for all groups by POM6, but there was no significant difference between the groups. 71% of patients identified as Hispanic (Table 1). There were 2 cases of rebound iritis in the iStent inject group, a case of 1 mm hyphema and steroid response in the Hydrus group, and one patient with an IOP spike in the KDB group, all of which were self-limiting.

Conclusions : The MIGS procedures of iStent inject, Hydrus, and Kahook dual blade combined with cataract surgery are safe and effective at lowering IOP, improving visual acuity, and decreasing dependence on drops. However, there was little significant difference found between the groups. Only iStent inject had a significantly lower number of glaucoma medications at both pre-op and POM6. The high percentage of Hispanic patients in this study should be considered when reviewing this data and may be an area of further investigation.

This is a 2021 ARVO Annual Meeting abstract.

 

 

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