June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Long Term Clinical and Visual Field Outcomes Following Minimally Invasive Glaucoma Surgery Combined with Cataract Surgery
Author Affiliations & Notes
  • Marcus Lawrence Turner
    University of California San Francisco, San Francisco, California, United States
  • Sean Yonamine
    University of California San Francisco, San Francisco, California, United States
  • Abu Taha
    University of California San Francisco, San Francisco, California, United States
  • Murtaza Saifee
    University of California San Francisco, San Francisco, California, United States
  • Mike Yang
    Prism Eye Institute, Ontario, Canada
  • Gui-Shuang Ying
    Penn Medicine, Philadelphia, Pennsylvania, United States
  • Ying Han
    University of California San Francisco, San Francisco, California, United States
  • Julius Oatts
    University of California San Francisco, San Francisco, California, United States
  • Footnotes
    Commercial Relationships   Marcus Turner None; Sean Yonamine None; Abu Taha None; Murtaza Saifee None; Mike Yang None; Gui-Shuang Ying None; Ying Han None; Julius Oatts None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3679 – A0364. doi:
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    • Get Citation

      Marcus Lawrence Turner, Sean Yonamine, Abu Taha, Murtaza Saifee, Mike Yang, Gui-Shuang Ying, Ying Han, Julius Oatts; Long Term Clinical and Visual Field Outcomes Following Minimally Invasive Glaucoma Surgery Combined with Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3679 – A0364.

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

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Abstract

Purpose : The use of minimally invasive glaucoma surgery (MIGS) during cataract surgery for patients with glaucoma has increased, accelerated by shorter surgical times and potentially less complications compared to glaucoma drainage device (GDD) implantation or trabeculectomy. Additionally, MIGS may help decrease eye drop burden, which is limited by patient adherence and can cause ocular surface toxicity. While several studies have evaluated clinical parameters following MIGS, information about longer term visual field (VF) outcomes is not widely available. The goal of this study is to evaluate long term clinical and VF outcomes following MIGS combined with cataract surgery.

Methods : This is a retrospective single-center case series of patients with glaucoma who had MIGS during cataract surgery between 11/2015 and 10/2019. Inclusion criteria were at least a 1-year of post-operative follow up, no history of prior incisional surgery, a reliable pre-operative VF, and a reliable post-operative VF at least 1 year after surgery. Clinical and VF metrics were assessed pre-operatively and at 1, 2, and 3 years post-operatively. Data collected included visual acuity (VA), intraocular pressure (IOP), number of glaucoma medications, VF mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI).

Results : 73 eyes of 60 patients were included, 50% male. The most common glaucoma diagnosis was primary open angle glaucoma (81%). MIGS devices included iStent, Trabectome, and Cypass Micro-Stent. Mean±SD IOP before surgery was 16.8±3.6 mmHg on 2.4±1.3 medications. At 3-year follow up (n=34 eyes), mean IOP was 16.4±2.9 mmHg (P=0.07) on 1.5± 1.4 glaucoma medications (P<0.001). Baseline VF metrics included MD of -6.2±5.9 dB, PSD of 5.3±4.0 dB, and VFI of 84±19%. There were no significant changes in MD, PSD, or VFI over time compared to baseline. VA improved from LogMAR 0.19±0.14 pre-operatively to 0.08±0.15 post-operatively (P<0.001).

Conclusions : Over the 3 year post-operative period of our cohort, MIGS combined with cataract surgery was associated with stable VF metrics as well as stable IOP with significant reduction in the number of glaucoma medications.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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