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Micro-Invasive Glaucoma Surgery with the iStent inject: Impact on IOP and Medication Burden in a Real-World Setting

DOI: 10.4236/ojoph.2020.101011, PP. 89-98

Keywords: iStent inject, MIGS, Glaucoma, Intraocular Pressure, Visual Acuity, Medica-tion Need

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Abstract:

Background: The iStent inject is a Micro-Invasive Glaucoma Surgical (MIGS) device that has shown to reduce IOP and to be safe for glaucoma patients with fewer complications than regular surgery. Objective: To investigate, up to 15 - 20 months, the efficacy and safety of implantation of two second-generation trabecular microbypass stents in patients with or without prior glaucoma surgery. Methods: Fifty-seven eyes were implanted with the iStent inject. The population was comprised of eyes with primary open-angle glaucoma (n = 51), pseudoexfoliation glaucoma (n = 5) and ocular hypertension (n = 1). Major outcome parameters included IOP, medication needs and corrected distance visual acuity (CDVA). Follow-up time points were one day, 2 - 4 months, 9 - 14 months and 15 - 20 months. Results: The main reason to perform MIGS was IOP reduction in 68.4%, reduced number of medications due to drug intolerance in 24.6% and reduced medication due to compliance issues in 7.0% of the eyes. IOP decreased by 22.47%, from 19.40 ± 3.83 mmHg preoperatively (preop) to 15.04 ± 1.67 mmHg at 15-20 months postoperatively. IOP reduction was achieved at all follow-up time points (p < 0.001). A decrease in the number of medications was achieved in 32.1% of the patients after 15 - 20 months. Conclusions: Insertion of the iStent inject in patients with or without prior glaucoma surgery shows effective and sustained improvements in IOP with no safety concerns.

References

[1]  Hengerer, F.H., Auffarth, G.U., Riffel, C. and Conrad-Hengerer, I. (2019) Second-Generation Trabecular Micro-Bypass Stents as Standalone Treatment for Glaucoma: A 36-Month Prospective Study. Advances in Therapy, 36, 1606-1617.
https://doi.org/10.1007/s12325-019-00984-9
[2]  Fingeret, M. and Dickerson Jr., J.E. (2018) The Role of Minimally Invasive Glaucoma Surgery Devices in the Management of Glaucoma. Optometry and Vision Science, 95, 155-162. https://doi.org/10.1097/OPX.0000000000001173
[3]  Katz, L.J., Erb, C., Carceller Guillamet, A., Fea, A.M., Voskanyan, L., Giamporcaro, J.E., et al. (2018) Long-Term Titrated IOP Control with One, Two, or Three Trabecular Micro-Bypass Stents in Open-Angle Glaucoma Subjects on Topical Hypotensive Medication: 42-Month Outcomes. Clinical Ophthalmology, 12, 255-262.
https://doi.org/10.2147/OPTH.S152268
[4]  Seibold, L.K., Gamett, K.M., Kennedy, J.B., Mulvahill, M.J., Kroehl, M.E., SooHoo, J.R., et al. (2016) Outcomes after Combined Phacoemulsification and Trabecular Microbypass Stent Implantation in Controlled Open-Angle Glaucoma. Journal of Cataract and Refractive Surgery, 42, 1332-1338.
https://doi.org/10.1016/j.jcrs.2016.07.023
[5]  Ferguson, T.J., Berdahl, J.P., Schweitzer, J.A. and Sudhagoni, R.G. (2016) Clinical Evaluation of a Trabecular Microbypass Stent with Phacoemulsification in Patients with Open-Angle Glaucoma and Cataract. Clinical Ophthalmology, 10, 1767-1773.
https://doi.org/10.2147/OPTH.S114306
[6]  Berdahl, J.P., Khatana, A.K., Katz, L.J., Herndon, L., Layton, A.J., Yu, T.M., et al. (2017) Cost-Comparison of Two Trabecular Micro-Bypass Stents versus Selective Laser Trabeculoplasty or Medications Only for Intraocular Pressure Control for Patients with Open-Angle Glaucoma. Journal of Medical Economics, 20, 760-766.
https://doi.org/10.1080/13696998.2017.1327439
[7]  Clement, C.I., Howes, F., Ioannidis, A.S., Shiu, M. and Manning, D. (2019) One-Year Outcomes Following Implantation of Second-Generation Trabecular Micro-Bypass Stents in Conjunction with Cataract Surgery for Various Types of Glaucoma or Ocular Hypertension: Multicenter, Multi-Surgeon Study. Clinical Ophthalmology, 13, 491-499. https://doi.org/10.2147/OPTH.S187272
[8]  Chen, D.Z. and Sng, C.C.A. (2017) Safety and Efficacy of Microinvasive Glaucoma Surgery. Journal of Ophthalmology, 2017, Article ID 3182935.
https://doi.org/10.1155/2017/3182935
[9]  Fea, A.M., Belda, J.I., Rekas, M., Junemann, A., Chang, L., Pablo, L., et al. (2014) Prospective Unmasked Randomized Evaluation of the iStent Inject (R) versus Two Ocular Hypotensive Agents in Patients with Primary Open-Angle Glaucoma. Clinical Ophthalmology, 8, 875-882. https://doi.org/10.2147/OPTH.S59932
[10]  Guedes, R.A.P., Gravina, D.M., Lake, J.C., Guedes, V.M.P. and Chaoubah, A. (2019) Intermediate Results of iStent or iStent Inject Implantation Combined with Cataract Surgery in a Real-World Setting: A Longitudinal Retrospective Study. Ophthalmology and Therapy, 8, 87-100. https://doi.org/10.1007/s40123-019-0166-x
[11]  Wang, S.Y., Singh, K., Stein, J.D. and Chang, R.T. (2019) Ocular Antihypertensive Medication Use after iStent Implantation Concurrent with Cataract Surgery vs. Cataract Surgery Alone in a Large US Health Care Claims Database. JAMA Ophthalmology, 137, 21-27.
https://doi.org/10.1001/jamaophthalmol.2018.4461
[12]  Arriola-Villalobos, P., Martinez-de-la-Casa, J.M., Diaz-Valle, D., Morales-Fernandez, L., Fernandez-Perez, C. and Garcia-Feijoo, J. (2016) Glaukos iStent Inject (R) Trabecular Micro-Bypass Implantation Associated with Cataract Surgery in Patients with Coexisting Cataract and Open-Angle Glaucoma or Ocular Hypertension: A Long-Term Study. Journal of Ophthalmology, 2016, Article ID 1056573.
https://doi.org/10.1155/2016/1056573
[13]  Samuelson, T.W., Sarkisian Jr., S.R., Lubeck, D.M., Stiles, M.C., Duh, Y.J., Romo, E.A., et al. (2019) Prospective, Randomized, Controlled Pivotal Trial of an Ab Interno Implanted Trabecular Micro-Bypass in Primary Open-Angle Glaucoma and Cataract: Two-Year Results. Ophthalmology, 126, 811-821.
https://doi.org/10.1016/j.ophtha.2019.03.006
[14]  Biggerstaff, K.S. and Lin, A. (2018) Glaucoma and Quality of Life. International Ophthalmology Clinics, 58, 11-22. https://doi.org/10.1097/IIO.0000000000000230

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