Good results seen with SIBS microshunt at 3 years
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NASHVILLE, Tenn. — Patients with open-angle glaucoma had favorable outcome 3 years after undergoing stand-alone SIBS microshunt implantation, according to a study.
“The SIBS microshunt is an implantable glaucoma device made from the same bioinert, non-reactive material that is found in coronary artery stents,” James J. Armstrong, MD, PhD, said at the American Glaucoma Society meeting. “There are two important elements to its design. First, its 7-µm lumen and 8.5 mm length were engineered to limit outflow at lower IOPs, reducing hypotony risk. Second, the device has two radial fins separating the proximal and distal segments to help secure the device within the scleral tract.”
The study included 152 eyes of 135 patients with open-angle glaucoma who underwent SIBS microshunt implantation with intraoperative mitomycin C. The median IOP at baseline was 20 mm Hg, while the median number of medications was four.
At 1 year after treatment, 74% of patients were categorized as a complete success, defined as IOP between 6 mm Hg and 17 mm Hg with at least a 20% reduction in IOP from baseline and no medication use. Complete success was achieved in 61% at 2 years and 52% at 3 years.
Qualified success was defined as IOP between 6 mm Hg and 17 mm Hg with at least a 20% reduction in IOP from baseline; 87% reached that mark at 1 year, 77% at 2 years and 70% at 3 years.
The mean IOP reduction was 7 mm Hg. At last follow-up, 61% of patients were not using medication.
The overall complication rate was 29%. Fifteen percent of cases underwent postoperative needling, while 7% underwent revision and 3% underwent reoperation.
Lower-concentration MMC was associated with higher rates of surgical failure and reoperation, while higher-concentration MMC was associated with more frequent minor complications.
“Over the 3 years of follow-up, the SIBS microshunt demonstrates encouraging rates of complete and qualified success as a stand-alone primary intervention in open-angle glaucoma patients,” Armstrong said.
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Armstrong JJ, et al. Ab externo SIBS microshunt with mitomycin C for open-angle glaucoma: 3-year results as a primary surgical intervention. Presented at: American Glaucoma Society meeting; March 3-6, 2022; Nashville, Tennessee.
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