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iStent with cataract surgery lowers IOP, medication use
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SAN DIEGO — A trabecular micro-bypass stent in conjunction with cataract surgery lowers IOP and medication use in open-angle glaucoma patients, a speaker said here.
In a presentation at the American Society of Cataract and Refractive Surgery meeting, John P. Berdahl, MD, discussed a retrospective case review of 309 consecutive open-angle glaucoma eyes implanted with an iStent (Glaukos) and followed for 1 year.
John P. Berdahl
There was a 9.7% incidence of IOP spikes of more than 15 mm Hg. One patient needed an Ahmed glaucoma valve (New World Medical), and one patient needed a Baerveldt shunt (Abbott Medical Optics).
“I pushed the limits pretty hard with these patients, and I’m happy to report the number of tube shunts and trabeculectomies that I do have calmed down significantly,” Berdahl said.
Average preoperative IOP was 18.8 mm Hg with an average of 1.2 medications. At 1 year, average IOP decreased by approximately 3 mm Hg to 15.7 mm Hg, and average medications decreased to 0.7 (P = .001).
Eyes that had preop IOP of 27 mm Hg or higher had a reduction of almost 12 mm Hg, compared with eyes that had preop IOP between 14 mm Hg and 17 mm Hg, which had an approximate reduction of 1 mm Hg.
“The IOP reduction definitely correlates with preoperative IOP,” Berdahl said. “This is a very safe surgery, and I think that even with our more aggressive glaucoma patients, it can help us to go on to treating even more aggressively in glaucoma surgery.” - by Kristie L. Kahl
Disclosure: Berdahl reports he is a consultant for Abbott Medical Optics, Alcon, Allergan, Avedro, ClarVista, Glaukos and Omega Ophthalmics; a researcher for Alcon and Glaukos; and an investor for Avedro and Omega Ophthalmics.