Two iStents significantly reduce IOP in open-angle glaucoma patients over long term

Issue: January 10, 2016

Implantation of two trabecular micro-bypass stents yielded a significant, sustained reduction of IOP in patients with open-angle glaucoma, according to a study.

The prospective pilot study included 39 phakic and pseudophakic patients with open-angle glaucoma who underwent microinvasive glaucoma surgery with two iStent trabecular micro-bypass stents (Glaukos). Preoperative IOP after medication washout was between 22 mm Hg and 38 mm Hg.

IOP, medication use and safety were evaluated at 1 day, 1 week, 1, 3, 6 and 12 months, and semi-annually out to 60 months postoperatively. Patients in this analysis were followed out to 36 months after surgery.

At 12 months, 36 eyes (92.3%) reached the primary efficacy endpoint of a 20% reduction in IOP from baseline without ocular hypotensive medication.

At varying time points over the 36-month follow-up, four patients required medication.

Patients who did not take medication had a mean IOP of 15.2 mm Hg at 36 months, a 37% decrease from the unmedicated baseline IOP.

Three patients who were on ocular hypotensive medications at 12 months were considered nonresponsive for each efficacy endpoint. No patients underwent a secondary surgical intervention before 12 months that could have an effect on IOP.

Best corrected visual acuity decreased by one or more lines in three eyes because of progression of concomitant cataract that was unrelated to stent implantation.

Ten adverse events occurred in eight eyes. One case of early postoperative hyphema resolved within 1 week. – by Matt Hasson

Disclosure: See the study for a full list of all authors’ relevant financial disclosures.

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Source:

Donnenfeld ED, et al. Clin Ophthalmol. 2015;doi:10.2147/OPTH.S91732.