Abstract
Purpose :
In the most recent decade, there has been a tremendous interest in the adoption of angle-based microinvasive glaucoma surgery (MIGS) devices to manage glaucoma. One such device is the iStent ® Trabecular Micro-Bypass device, which was the 1st MIGS device approved for glaucoma at the time of cataract surgery in the United States. In some cases, the iStent implantation has been observed to show intraoperative adverse events such as cyclodialysis clefts, device blockage, corneal edema, and hyphema. In the present study, we have investigated the involvement of demographic variables associated with the development of adverse events related to iStent implants.
Methods :
A Robust EHR database ((Health Facts®) provided a unique opportunity for risk assessment with a large retrospective data analysis. We retrieved 171 patient records, which included their laboratory tests, medication, surgical procedures, and diagnostic and demographic information. Using these tools, we employed logistic regression and odds ratio analysis to predict risk factors associated with iStent failure.
Results :
In this retrospective study, we obtained 92 female and 79 male patients records ranging from 18 to 93 years across a wide demographic of ethnicities. Then, a regression analysis and odds ratio analysis was applied to identify the risk factors in a Big Data environment. The results suggest that African American race (p<0.01) is an important risk factor for iStent failure. Further analysis suggests that smokers have higher rate of iStent failure (p<0.01) compared to non-smoker groups. Using odds ratio analysis, we found that obesity and Type 2 diabetes Mellitus are statistically significant risk factors among the iStent failure group.
Conclusions :
The present study suggest that race, smoking status, obesity, and Type 2 Diabetes are significant risk factors for the development of iStent implant failure. Further understanding of these risk factors could enable physicians to better tailor the best minimally invasive glaucoma surgery device to the demographic of their patients at the time of cataract surgery.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.