February 28, 2014
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Study: Suprachoroidal shunt with topical travoprost reduces IOP

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WASHINGTON — Early study findings suggest that implantation of a suprachoroidal stent significantly reduces IOP and medication burden in phakic patients with open-angle glaucoma, according to a presenter here.

Perspective from L. Jay Katz, MD

In this study of the suprachoroidal shunt implantation with travoprost, there were substantial reductions in pressure, with all eyes achieving a pressure of 18 mm Hg or lower at 1 and 2 years, and most eyes achieving 15 mm Hg at 1 and 2 years,” Jonathan S. Myers, MD, said at the American Glaucoma Society meeting.

Jonathan S. Myers

Myers reported results of implantation of the iStent supra (Glaukos) suprachoroidal micro-bypass stent with postoperative travoprost in 41 of 80 subjects evaluable at 2 years in an ongoing 5-year prospective, single-arm, open-label study.

“The goal of this study was to evaluate pressure reduction when you put in an iStent supra and started the patient then on topical travoprost,” Meyers said. “We also looked at medication reduction.” Primary effectiveness endpoint was IOP reduction of at least 20% at 12 months with reduction of one ocular hypotensive medication.

“The vast majority of patients achieved a 30% and even 40% pressure reduction in comparison to their unmedicated baseline,” Myers said. “So, there is strong pressure reduction with the iStent suprachoroidal shunt and topical travoprost.”

Safety profile is excellent, according to Myers, with only two cases of hypotony being reported, and those were resolved within 1 month. One patient required trabeculectomy in one eye, and subsequent data on that patient was not included in the analysis.
The iStent supra is not approved by the U.S. Food and Drug Administration.

Disclosure: Myers receives research support from Alcon and Glaukos and is a consultant and speaker for Alcon.