Laser trabeculoplasty, iStent may not reduce patients’ medication burden
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NEW ORLEANS — The majority of patients who underwent laser trabeculoplasty or iStent implantation saw no tangible reduction in their health care burden, according to a study presented at the American Academy of Ophthalmology meeting.
“Treatment options are evolving with an increasing trend toward earlier management in terms of interventions, both surgically and the laser,” Eydie G. Miller-Ellis, MD, said. “However, there is sparse large-scale real-world data on the effectiveness of these interventional procedures in terms of glaucoma management.”
Miller-Ellis and colleagues conducted a retrospective cohort analysis of administrative claims from a national claims data supplier. Patients with a diagnosis of open-angle glaucoma or ocular hypertension who underwent laser trabeculoplasty or iStent (Glaukos) implantation between March 2018 and February 2019 were included in the study.
Researchers identified 29,941 patients who underwent laser trabeculoplasty and 7,761 patients who received an iStent.
Of the patients who underwent laser trabeculoplasty, 88.8% did not undergo a subsequent glaucoma procedure in the same eye within 12 months of the original procedure. Of the 11.2% of patients who did undergo a subsequent procedure, a repeated laser trabeculoplasty was the most common treatment, Miller-Ellis said.
Of the patients who received an iStent, 95.3% did not undergo a subsequent procedure in the following 12 months. Of the 4.7% who did, endoscopic cyclophotocoagulation and tube shunts were the most common procedures.
In terms of medication burden, 60.6% of patients who underwent laser trabeculoplasty saw no change in their number of medications, while 18.4% saw an increase. Patients who received an iStent fared similarly, with 57.4% seeing no change in medications and 12.3% seeing an increase in medications, Miller-Ellis said.
“A small proportion of patients who underwent these procedures had a subsequent glaucoma procedure in the same eye within 12 months of the iStent or laser trabeculoplasty. There was no reduction in the average medication burden post-procedure,” Miller-Ellis said. “There remains an unmet need for durable treatments to reduce the medication burden in glaucoma patients.”
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Miller-Ellis E, et al. Healthcare burden following laser trabeculoplasty and iStent in US clinical practice: Medication use and subsequent procedures. Presented at: American Academy of Ophthalmology meeting; Nov. 12-15, 2021; New Orleans.
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