Abstract
Purpose :
While trabeculectomy with mitomycin-C(MMC) is still the standard of surgical care in glaucoma, various microshunt devices show good promise as an alternative to trabeculectomy. Astream®, a recently developed glaucoma microshunt device in Korea, is expected to provide similar but more stable intraocular pressure (IOP) control compared to trabeculectomy owing to its design. This retrospective case series evaluated clinical outcomes of Astream® microshunt device.
Methods :
17 eyes from 17 patients with primary or secondary glaucoma who underwent Astream® implantation were retrospectively reviewed. Astream® is the first smallest MIGS that was developed in Korea, manufactured out of medical grade silicone with length of 6mm and tube diameter of 100 micrometer. Stylet positioned within its tube lumen is expected to deliver effective but safer IOP reduction by reducing risk of hypotony at early post-operative period. As the stylet occupying tube space can be easily removed at any post-operative period, it also provides effective IOP management at later post-operative period. All surgical procedures were performed by a single, experienced surgeon. Post-operative stylet removal was performed with physician’s discretion.
Results :
The cohort’s mean age, pre-operative visual field mean deviation (MD) and IOP were 63.06 ± 16.25, -16.54 ± 9.62 and 31.0 ± 14.89, respectively. Post-operatively, mean IOP at 1-week was 10.25 ± 3.64, and 13.08 ± 6.73 at 6-months. Number of glaucoma medications also significantly decreased from 3.12 ± 0.6 to 0.08 ± 0.27. No cases of early hypotony were observed and effective IOP reduction were achieved in all cases without complications. No post-operative interventions, such as needling or re-operation for glaucoma, were required in included all cases thus far.
Conclusions :
In this case series, the novel glaucoma microshunt device provides effective yet stable IOP reduction up to 6-month post-operative period. Nevertheless, further prospective study with larger sample size is required to demonstrate and support its effectiveness and safety.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.