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Combined trabecular micro-bypass stent, cataract surgery may improve IOP control
Patients who underwent single trabecular micro-bypass stent implantation and cataract surgery demonstrated significantly better IOP control without medication at 2 years than patients who underwent cataract surgery alone, according to a study.
The prospective, randomized, controlled clinical trial included patients with mild to moderate glaucoma and IOP between 22 mm Hg and 36 mm Hg at 29 sites in the United States. Cataract surgery and iStent (Glaukos) implantation were performed in 116 eyes, while a control group of 123 eyes underwent cataract surgery alone. Follow-up was 24 months.
Mean IOP was stable in patients in the stent group: 17.0 mm Hg ± 2.8 at 12 months and 17.1 ± 2.9 mm Hg at 24 months. In the control group, mean IOP increased from 17.0 ± 3.1 mm Hg at 12 months to 17.8 ± 3.3 mm Hg at 24 months.
The proportion of patients with IOP of 21 mm Hg or lower without medication was significantly higher in the stent group than the control group (P = .036).
“The potential to achieve a target IOP with a lower medication burden … is an unmet need for this elderly population,” study authors concluded. “Based on these findings over 2 years, iStent implantation appears to be a therapy that can be provided at the time of cataract surgery in patients with cataract and mild to moderate glaucoma.”