Real-world MIGS data show IOP reduction, low complication rate
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NASHVILLE, Tenn. — Patients who underwent MIGS procedures with and without phacoemulsification experienced IOP reductions and low complication rates, according to data from the IRIS Registry.
At the American Glaucoma Society meeting, Shuang-An Yang, MD, MPH, said MIGS procedures have emerged as alternative treatment options for patients with mild or moderate glaucoma.
“From our previous study looking at the trends of glaucoma surgery in the States, we found a substantial increase in MIGS in recent years,” she said. “However, MIGS effectiveness and long-term safety have not been fully demonstrated.”
Investigators analyzed data from patients who underwent at least one MIGS procedure — Xen gel stent (Allergan), endocyclophotocoagulation (ECP), goniotomy or canaloplasty — performed either alone or with phacoemulsification between 2013 and 2019. The primary outcome of the study was time to reoperation. Researchers also explored secondary endpoints, including mean change in IOP.
Yang and colleagues identified 72,122 eyes, including 14,002 that underwent stand-alone MIGS and 58,120 that underwent concurrent phacoemulsification.
Patients who underwent concurrent phacoemulsification had fewer reoperations than patients in the stand-alone MIGS group. At 1 year postoperatively, the cumulative reoperation rate was 13.4% for ECP, 17.1% for Xen and 17.5% for goniotomy/canaloplasty in the stand-alone group. In the phacoemulsification group, the reoperation rates were 3.4%, 11.9% and 3.5%, respectively (P < .001).
Although IOP decreased across all groups, patients who underwent stand-alone MIGS experienced more substantial decreases. Overall complication rates were 0.98% for ECP, 1.17% for Xen and 1.78% for goniotomy/canaloplasty.
“Our study indicates that MIGS combined with cataract surgery will have an increasing role in filling the treatment gap of patients with mild to moderate glaucoma and coexistent cataracts,” Yang said.
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Yang S, et al. Effectiveness of micro-invasive glaucoma surgery in the United States: IRIS Registry longitudinal analysis 2013-2019. Presented at: American Glaucoma Society meeting; March 3-6, 2022; Nashville, Tennessee.
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