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Multiple glaucoma stents during cataract surgery reduce IOP, medication use
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Implantation of two or three trabecular micro-bypass stents combined with cataract surgery lowered IOP in patients with open-angle glaucoma, according to a study.
“Implantation of multiple trabecular micro-bypass stents has the potential to further reduce IOP and topical ocular hypotensive medications vs. implantation of one trabecular micro-bypass stent,” the study authors said.
Investigators prospectively evaluated 53 eyes of 47 patients with open-angle glaucoma who received two or three iStent implants (Glaukos) and concurrent cataract surgery; 28 patients were implanted with two stents and 25 patients were implanted with three stents.
Mean patient age was 78.8 years in the two-stent group and 75 years in the three-stent group.
Snellen visual acuity, IOP, number of glaucoma medications, stent placement and complications were evaluated postoperatively at 1 day, 1 week, and 1, 3, 6 and 12 months. The efficacy measures were IOP and use of topical ocular hypotensive medications.
Study results showed that mean postoperative IOP at 1 year was 13.8 mm Hg in the two-stent group and 14.8 mm Hg in the three-stent group. IOP decreased a mean 3.9 mm Hg in the three-stent group and 3.5 mm Hg in the two-stent group; both decreases were statistically significant (P < .001).
Target IOP was attained in 20 eyes in the two-stent group (71%) and 21 eyes in the three-stent group (84%).
The number of medications was 0.4 in the three-stent group and 1 in the two-stent group; the between-group difference was statistically significant (P = .04).
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