Prospective evaluation of two iStent® trabecular stents, one iStent Supra® suprachoroidal stent, and postoperative prostaglandin in refractory glaucoma: 4-year outcomes
Introduction: This study evaluates long-term outcomes of two trabecular micro-bypass stents, one suprachoroidal stent, and postoperative prostaglandin in eyes with refractory open angle glaucoma (OAG). Methods: Prospective ongoing 5-year study of 80 eligible subjects (70 with 4-year follow-up) with...
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| Hauptverfasser: | , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
February 23, 2018
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| In: |
Advances in therapy
Year: 2018, Jahrgang: 35, Heft: 3, Pages: 395-407 |
| ISSN: | 1865-8652 |
| DOI: | 10.1007/s12325-018-0666-4 |
| Online-Zugang: | Verlag, Pay-per-use, Volltext: https://doi.org/10.1007/s12325-018-0666-4
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| Verfasserangaben: | Jonathan S. Myers, Imran Masood, Dana M. Hornbeak, Jose I. Belda, Gerd Auffarth, Anselm Jünemann, Jane Ellen Giamporcaro, Jose M. Martinez-de-la-Casa, Iqbal Ike K. Ahmed, Lilit Voskanyan, L. Jay Katz |
| Zusammenfassung: | Introduction: This study evaluates long-term outcomes of two trabecular micro-bypass stents, one suprachoroidal stent, and postoperative prostaglandin in eyes with refractory open angle glaucoma (OAG). Methods: Prospective ongoing 5-year study of 80 eligible subjects (70 with 4-year follow-up) with OAG and IOP ≥ 18 mmHg after prior trabeculectomy and while taking 1-3 glaucoma medications. Subjects received two iStent® trabecular micro-bypass stents, one iStent Supra® suprachoroidal stent, and postoperative travoprost. Postoperative IOP was measured with medication and annually following medication washouts. Performance was measured by the proportion of eyes with ≥ 20% IOP reduction on one medication (the protocol-specified prostaglandin) versus preoperative medicated IOP (primary outcome); and the proportion of eyes with postoperative IOP ≤ 15 and ≤ 18 mmHg on one medication (secondary outcome). Additional clinical and safety data included medications, visual field, pachymetry, gonioscopy, adverse events, visual acuity, and slit-lamp and fundus examinations. Results: Preoperatively, mean medicated IOP was 22.0 ± 3.1 mmHg on 1.2 ± 0.4 medications, and mean unmedicated IOP was 26.4 ± 2.4 mmHg. Postoperatively, among eyes without later cataract surgery, mean medicated IOP at all visits through 48 months was ≤ 13.7 mmHg (≥ 37% reduction), and annual unmedicated IOP was ≤ 18.4 mmHg (reductions of ≥ 30% vs. preoperative unmedicated IOP and ≥ 16% vs. preoperative medicated IOP). At all postoperative visits among eyes without additional surgery or medication, ≥ 91% of eyes had ≥ 20% IOP reduction on one medication versus preoperative medicated IOP. At month 48, 97 and 98% of eyes achieved IOP ≤ 15 and ≤ 18 mmHg, respectively, on one medication. Six eyes required additional medication, no eyes required additional glaucoma surgery, and safety measurements were favorable throughout follow-up. Conclusion: IOP control was achieved safely with two trabecular micro-bypass stents, one suprachoroidal stent, and postoperative prostaglandin. This microinvasive, ab interno approach introduces a possible new treatment option for refractory disease. |
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| Beschreibung: | Gesehen am 02.12.2019 |
| Beschreibung: | Online Resource |
| ISSN: | 1865-8652 |
| DOI: | 10.1007/s12325-018-0666-4 |