Trabecular microbypass stent implantation in pseudophakic eyes with open-angle glaucoma: Long-term results

J Cataract Refract Surg. 2019 Apr;45(4):414-420. doi: 10.1016/j.jcrs.2018.11.005. Epub 2019 Jan 29.

Abstract

Purpose: To evaluate the long-term safety and efficacy of a trabecular microbypass stent as a sole procedure in pseudophakic eyes with open-angle glaucoma.

Setting: Private practice; Sioux Falls, South Dakota, USA.

Design: Retrospective, consecutive case series.

Methods: The series included pseudophakic eyes of patients with mild to severe open-angle glaucoma (OAG) implanted with 1 trabecular microbypass stent. Data was collected at baseline before the surgery and at 1 day, 1 week, 1 month, and up to 48 months postoperatively. The data included intraocular pressure (IOP), number of glaucoma medications, and whether there was a requirement for secondary surgery.

Results: The study comprised 40 patients (51 eyes). The mean IOP was reduced from 20.33 mm Hg ± 4.83 (SD) at baseline to 15.65 ± 3.45 mm Hg at 48 months postoperatively, indicating a 23% reduction (P < .01). The mean number of glaucoma medications was 2.08 ± 1.06 preoperatively and 1.46 ± 1.07 at 48 months postoperatively (P > .05). Postoperatively, 3 eyes (6%) had IOP spikes of 15 mm Hg or higher than the preoperative value, which responded to topical therapy. Ten eyes (20%) required secondary glaucoma surgery. There were no postoperative or intraoperative complications. Patients who had previous ocular hypotensive medication use and an IOP of 18 mm Hg or higher achieved a statistically significant reduction in both IOP and medication use.

Conclusions: The insertion of a single trabecular microbypass stent effectively provided a sustained reduction in IOP in pseudophakic patients with mild to severe OAG. The IOP reduction was more robust in eyes that had a higher baseline IOP.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Female
  • Glaucoma Drainage Implants*
  • Glaucoma, Open-Angle / physiopathology
  • Glaucoma, Open-Angle / surgery*
  • Humans
  • Intraocular Pressure
  • Male
  • Prosthesis Implantation
  • Pseudophakia / etiology*
  • Retrospective Studies
  • Stents*
  • Tonometry, Ocular
  • Trabecular Meshwork / surgery*

Substances

  • Antihypertensive Agents