|Articles|February 15, 2016

Minimally invasive glaucoma procedure replicates trabeculectomy efficacy with superior safety profile

Twenty-two of 23 eyes with a trans-scleral micro-lumen aqueous drainage tube implanted after failing maximum tolerated medication were evaluable at 3 years.

TAKE HOME MESSAGE: Twenty-two of 23 eyes with a trans-scleral micro-lumen aqueous drainage tube implanted after failing maximum tolerated medication were evaluable at 3 years.

Reviewed by Juan F. Batlle, MD

Santo Domingo, Dominican Republic-Implantation of a trans-scleral micro-lumen aqueous drainage tube (InnFocus MicroShunt, InnFocus)-as a standalone procedure or combined with cataract surgery-is safe and provides sustained lowering of IOP while reducing the need for medication, said Juan F. Batlle, MD.

Results from three years of follow-up in a prospective non-randomized trial were highlighted by Dr. Batlle, director, Centro Laser, and director, Elias Santana Charity Hospital, Santo Domingo.

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Dr. Batlle is an investigator in the study enrolling 23 eyes considered eligible for trabeculectomy after failing maximum tolerated glaucoma medication. The trans-scleral aqueous drainage tube was implanted alone in 14 eyes and combined with cataract surgery in 9 eyes. In all cases, mitomycin-C (MMC) 0.4 mg/mL was applied intraoperatively for 3 minutes.

Twenty-two eyes were available for follow-up at 3 years. Mean IOP was 23.8 ± 5.3 mm Hg preoperatively and reduced at last follow-up by 55% to 10.7 ± 3.5 mm Hg. Mean daily medication use was reduced from 2.4 ± 0.9 to 0.5 ± 0.9.

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Twenty-one (95%) eyes met the criteria for qualified success (IOP ≤ 21 mm Hg and ≥ 20% reduction in IOP from baseline with or without medication), and complete success, defined by the same IOP criteria without medication, was achieved by 16 (73%) eyes.

The most common complications encountered in the series were immediate postoperative hypotony, which occurred in 3 eyes (13%), and transient choroidal effusion in 2 eyes (8.7%). All of those events were transient and resolved spontaneously without sequelae, and there were no sight-threatening adverse events.

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