Using multiple trabecular micro-bypass stents in cataract patients to treat open-angle glaucoma

• Published in: Journal of cataract and refractive surgery Vol. 38; no. 11; pp. 1911 - 1917
• Main Authors: Belovay, Graham W., MD, Naqi, Abdulla, MD, Chan, Brian J., MD, Rateb, Mahmoud, MD, Ahmed, Iqbal Ike K., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2012; Elsevier
• Subjects: Aged; Antihypertensive Agents - administration & dosage; Biological and medical sciences; Cataract - complications; Female; Glaucoma and intraocular pressure; Glaucoma, Open-Angle - complications; Glaucoma, Open-Angle - surgery; Humans; Intraocular Pressure - physiology; Iridectomy; Lens diseases; Lens Implantation, Intraocular; Male; Medical sciences; Ophthalmology; Phacoemulsification; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Stents; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Tonometry, Ocular; Trabeculectomy; Visual Acuity - physiology; Human; Eye disease; Cataract; Lens disease; Multiple; Open angle glaucoma; Bypass; Surgery; Instrumentation therapy; Ophthalmology; Stent; Anterior segment disease
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2012.07.017

Purpose To evaluate the efficacy of multiple trabecular micro-bypass stents combined with cataract surgery in patients with open-angle glaucoma (OAG) and cataract. Setting Private practice, Mississauga, Ontario, Canada. Design Comparative case series. Methods Eyes with OAG had implantation of 2 or 3 micro-bypass stents with concurrent cataract surgery and follow-up through 1 year. Efficacy measures were intraocular pressure (IOP) and topical ocular hypotensive medication use. Safety assessment included complications and corrected distance visual acuity (CDVA). Results The study comprised 53 eyes (47 patients); 28 had implantation of 2 stents and 25 had implantation of 3 stents. The overall mean 1-year postoperative IOP was 14.3 mm Hg, which was significantly lower than preoperative IOP overall and in each group ( P <.001). The target IOP was achieved in a significantly higher proportion of eyes at 1 year versus preoperatively (77% versus 43%; P <.001). Overall, 83% of eyes had a decrease in topical ocular hypotensive medication at 1 year from preoperatively, with a 74% decrease in the mean number of medications (from 2.7 to 0.7) at 1 year ( P <.001). The 3-stent group was on significantly fewer medications than the 2-stent group at 1 year (0.4 versus 1.0; P =.04). Conclusions Using multiple micro-bypass stents with concurrent cataract surgery led to a mean postoperative IOP of less than 15 mm Hg and allowed patients to achieve target pressure control with significantly fewer medications through 1 year. Financial Disclosure Dr. Ahmed is a consultant to Glaukos Corp. No other author has a financial or proprietary interest in any material or method mentioned.