November 2012

 

RESIDENTS

 

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


Graham W. Belovay, M.D., Abdulla Naqi, M.D., Brian J. Chan, B.H.Sc., Mahmoud Rateb, M.D., Iqbal (Ike) K. Ahmed, M.D.

   

J Cataract Refract Surg (Nov) 2012; 38: 1911-1917

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 post-operative IOP was 14.3 mm Hg, which was significantly lower than pre-operative IOP overall and in each group (P<.001). The target IOP was achieved in a significantly higher proportion of eyes at 1 year versus pre-operatively (77% versus 43%; P<.001). Overall, 83% of eyes had a decrease in topical ocular hypotensive medication at 1 year from pre-operatively, 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 post-operative 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.

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