Impressive IOP results from second-generation microinvasive surgery

Reviewed by Fritz Hengerer, MD, PhD

TAKE HOME MESSAGE: Follow-up to one year for a consecutive series of 29 eyes with open-angle glaucoma and IOP uncontrolled by medication and/or surgery show impressive IOP lowering and reduction of medication use after implantation of two second-generation trabecular micro-bypass stents.

Frankfurt, Germany-Implantation of two second-generation trabecular micro-bypass stents (iStent inject, Glaukos) as a single procedure or combined with cataract surgery is a safe and effective option for reducing IOP and the medication burden in eyes with open-angle glaucoma and IOP uncontrolled by medication and/or surgery, according to German surgeons.

Analyses of outcomes from a consecutive series of 29 eyes (22 patients) that underwent the glaucoma surgery showed mean medicated IOP was reduced from 24.3 mm Hg at baseline to 14.8 mm Hg at three months when 27 eyes were available for follow-up.

Among 22 eyes evaluated at one year, mean IOP was 13.8 mm Hg (–43% change from baseline). Mean daily medication use was reduced by 86% from 2.8 at baseline to 0.6; 45% of patients were on no medications, 50% were using a single agent, one patient was on two medications, and no one was using more than two medications.

There were no intraoperative sequelae, and during follow-up to one year, safety remained excellent, said Fritz Hengerer, MD, PhD, deputy director and senior head physician, Goethe University, Frankfurt, Germany.

“All implantations were completed without endothelial or lens contact or other untoward events,” he said. “Follow-up is continuing and is now approaching 18 months. Visual acuity has remained stable and IOP is also being maintained close to the 12-month level.”

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