Cyclophotocoagulation with trabecular meshwork bypass MIGS may lead to sustained IOP reduction
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WASHINGTON — Patients with advanced open-angle glaucoma experienced a sustained IOP and medication reduction after undergoing cyclophotocoagulation combined with trabecular meshwork bypass MIGS, according to the co-author of a poster here.
“Combining multiple MIGS procedures, such as gentle or targeted cyclophotocoagulation combined with a trabecular meshwork bypass outflow MIGS, can produce significant pressure reduction that may be superior than either would accomplish alone,” poster co-author Won Kim, MD, told Healio/OSN.
The retrospective, noncomparative study evaluated 41 patients with advanced glaucoma who underwent combined cyclophotocoagulation with trabecular meshwork bypass MIGS. According to the poster, the techniques used were trabecular bypass stents, excisional/ablative goniotomy, circumferential ab interno trabeculotomy and ab interno canaloplasty.
At 12 months, the 12 patients remaining in the cohort had an IOP of 12.8 mm Hg, reduced from 21.6 mm Hg preoperatively. Medications were reduced from 3.4 preoperatively to 1.9 at 12 months. At 24 months, the 10 remaining patients reported an IOP of 12.2 mm Hg and 2.4 medications, according to the poster.
“Patients achieved IOP in the low teens consistently, experienced a modest reduction in medication burden with low complication rates and a reasonable failure rate,” Kim said.
The combined procedure also proved successful in patients with significant visual field loss and in those who had already failed prior trabeculectomy and drainage implants, Kim said. – by Robert Linnehan
Reference:
Kim W. Outcomes of combined cyclophotocoagulation with trabecular meshwork bypass minimally invasive glaucoma surgeries in the treatment of advanced open-angle glaucoma. Presented at: American Glaucoma Society annual meeting; Feb. 27-March 1, 2020; Washington.
Disclosure: Kim reports no relevant financial disclosures.