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

Abstract

To evaluate the long-term safety and efficacy of a trabecular microbypass stent as a sole procedure in pseudophakic eyes with open-angle glaucoma. Private practice; Sioux Falls, South Dakota, USA. Retrospective, consecutive case series. 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 1day, 1week, 1month, and up to 48months postoperatively. The data included intraocular pressure (IOP), number of glaucoma medications, and whether there was a requirement for secondary surgery. The study comprised 40 patients (51 eyes). The mean IOP was reduced from 20.33mm Hg±4.83 (SD) at baseline to 15.65±3.45mm Hg at 48months 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 48months postoperatively (P>.05). Postoperatively, 3 eyes (6%)had IOP spikes of 15mm 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 18mm Hg or higher achieved a statistically significant reduction in both IOP and medication use. 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.