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Second-generation micro-bypass stent significantly lowers IOP, medication intake
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WARSAW, Poland — Results of the Micro-Invasive Glaucoma Surgery Study Group with the second-generation trabecular micro-bypass iStent inject implanted with a single-use injector showed a significant decrease in IOP and number of medications with a favorable safety outcome.
Manfred Tetz
The iStent inject (Glaukos) is single-piece, miniature, collar button-shaped heparin-coated titanium stent, implanted ab interno into Schlemm’s canal. Multiple lateral lumens are designed to provide an exit route for the aqueous from the anterior chamber, Manfred Tetz, MD, explained at the winter meeting of the European Society of Cataract and Refractive Surgeons.
“Results are significantly better compared with the previous-generation iStent,” he said.
In the study, two stents were implanted at 1 to 2 clock hours distance in 100 eyes with moderate to advanced glaucoma. Ten eyes underwent stent implantation during cataract surgery. Nine eyes had undergone 11 prior glaucoma surgeries, including seven trabeculectomies and four laser trabeculoplasties. Fifty patients have reached 1 year of follow-up.
“Mean IOP decreased from preoperative 24 mm Hg to 14.5 mm Hg throughout the follow-up. The mean number of ocular hypotensive medications decreased from an average of 1.8 preoperatively to 0.2 or less at 1 year, with 82% of the patients being completely off medications,” Tetz said.
Best corrected visual acuity was improved or maintained within one line from preop in 94% of the eyes. No intraoperative adverse events were reported. Postoperatively, one eye with dense cataract developed corneal edema.
“Surgery is reproducible and relatively quick, the injector is easy to handle, and results are promising,” Tetz said.
Disclosure: Tetz has no relevant financial disclosures.