Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results

Abstract Background The short- and medium-term outcomes of iStent have been extensively studied; however, only few studies have investigated its long-term outcomes. Here, we assessed the long-term efficacy and safety of two iStents with concomitant cataract surgery in glaucomatous eyes while also ev...

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Autores principales:	Ali Salimi, Harrison Watt, Paul Harasymowycz
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Minimally invasive glaucoma surgery MIGS Trabecular micro-bypass stent iStent Glaucoma Cataract surgery Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/37adcc268d654989895ae80d3a707fdf
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spelling	oai:doaj.org-article:37adcc268d654989895ae80d3a707fdf2021-11-21T12:25:30ZLong-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results10.1186/s40662-021-00263-12326-0254https://doaj.org/article/37adcc268d654989895ae80d3a707fdf2021-11-01T00:00:00Zhttps://doi.org/10.1186/s40662-021-00263-1https://doaj.org/toc/2326-0254Abstract Background The short- and medium-term outcomes of iStent have been extensively studied; however, only few studies have investigated its long-term outcomes. Here, we assessed the long-term efficacy and safety of two iStents with concomitant cataract surgery in glaucomatous eyes while also evaluating measures of disease stability using visual field and optical coherence tomography (OCT) of the optic nerve and the macula throughout 8 years of follow-up. Methods This longitudinal, single-center consecutive case series included glaucomatous eyes that underwent implantation of two first-generation trabecular micro-bypass stents (iStent) with concomitant cataract surgery. Eight-year efficacy outcomes included mean intraocular pressure (IOP) and medications, as well as surgical success. Eight-year safety outcomes included best-corrected visual acuity (BCVA), visual field mean deviation (VF-MD), cup-to-disc ratio (CDR), retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, and adverse events. Results A total of 62 eyes with primary open-angle glaucoma (POAG) were included. At 8 years postoperative, IOP reduced by 26% from 19.2 ± 3.9 mmHg preoperatively to 14.2 ± 2.4 mmHg (P < 0.001), 91.1% of eyes achieved IOP ≤ 18 mmHg (vs. 51.6% preoperatively), 69.6% of eyes achieved IOP ≤ 15 mmHg (vs. 14.5% preoperatively), and 25% of eyes achieved IOP ≤ 12 mmHg (vs. 1.6% preoperatively). Medication use decreased by 17.9% from 2.8 ± 1.1 preoperatively to 2.3 ± 1.2 (P = 0.018). Surgical success was 90%, as six eyes underwent subsequent glaucoma surgeries. Safety measures of BCVA, CDR, RNFL thickness and GC-IPL thickness remained stable through 8 years postoperative. VF-MD remained stable until postoperative year 5 and subsequently progressed according to the natural history of glaucomatous disease. Conclusions Implantation of two iStents with concomitant cataract surgery is an effective and safe treatment option for surgery-naïve POAG eyes, evidenced by significant IOP and medication reductions, reasonable surgical success, and favorable safety outcomes, throughout the 8-year follow-up. Our data additionally supports the efficacy of this combined procedure in stabilizing or slowing disease progression.Ali SalimiHarrison WattPaul HarasymowyczBMCarticleMinimally invasive glaucoma surgeryMIGSTrabecular micro-bypass stentiStentGlaucomaCataract surgeryOphthalmologyRE1-994ENEye and Vision, Vol 8, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Minimally invasive glaucoma surgery MIGS Trabecular micro-bypass stent iStent Glaucoma Cataract surgery Ophthalmology RE1-994
spellingShingle	Minimally invasive glaucoma surgery MIGS Trabecular micro-bypass stent iStent Glaucoma Cataract surgery Ophthalmology RE1-994 Ali Salimi Harrison Watt Paul Harasymowycz Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results
description	Abstract Background The short- and medium-term outcomes of iStent have been extensively studied; however, only few studies have investigated its long-term outcomes. Here, we assessed the long-term efficacy and safety of two iStents with concomitant cataract surgery in glaucomatous eyes while also evaluating measures of disease stability using visual field and optical coherence tomography (OCT) of the optic nerve and the macula throughout 8 years of follow-up. Methods This longitudinal, single-center consecutive case series included glaucomatous eyes that underwent implantation of two first-generation trabecular micro-bypass stents (iStent) with concomitant cataract surgery. Eight-year efficacy outcomes included mean intraocular pressure (IOP) and medications, as well as surgical success. Eight-year safety outcomes included best-corrected visual acuity (BCVA), visual field mean deviation (VF-MD), cup-to-disc ratio (CDR), retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, and adverse events. Results A total of 62 eyes with primary open-angle glaucoma (POAG) were included. At 8 years postoperative, IOP reduced by 26% from 19.2 ± 3.9 mmHg preoperatively to 14.2 ± 2.4 mmHg (P < 0.001), 91.1% of eyes achieved IOP ≤ 18 mmHg (vs. 51.6% preoperatively), 69.6% of eyes achieved IOP ≤ 15 mmHg (vs. 14.5% preoperatively), and 25% of eyes achieved IOP ≤ 12 mmHg (vs. 1.6% preoperatively). Medication use decreased by 17.9% from 2.8 ± 1.1 preoperatively to 2.3 ± 1.2 (P = 0.018). Surgical success was 90%, as six eyes underwent subsequent glaucoma surgeries. Safety measures of BCVA, CDR, RNFL thickness and GC-IPL thickness remained stable through 8 years postoperative. VF-MD remained stable until postoperative year 5 and subsequently progressed according to the natural history of glaucomatous disease. Conclusions Implantation of two iStents with concomitant cataract surgery is an effective and safe treatment option for surgery-naïve POAG eyes, evidenced by significant IOP and medication reductions, reasonable surgical success, and favorable safety outcomes, throughout the 8-year follow-up. Our data additionally supports the efficacy of this combined procedure in stabilizing or slowing disease progression.
format	article
author	Ali Salimi Harrison Watt Paul Harasymowycz
author_facet	Ali Salimi Harrison Watt Paul Harasymowycz
author_sort	Ali Salimi
title	Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results
title_short	Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results
title_full	Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results
title_fullStr	Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results
title_full_unstemmed	Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results
title_sort	long-term outcomes of two first-generation trabecular micro-bypass stents (istent) with phacoemulsification in primary open-angle glaucoma: eight-year results
publisher	BMC
publishDate	2021
url	https://doaj.org/article/37adcc268d654989895ae80d3a707fdf
work_keys_str_mv	AT alisalimi longtermoutcomesoftwofirstgenerationtrabecularmicrobypassstentsistentwithphacoemulsificationinprimaryopenangleglaucomaeightyearresults AT harrisonwatt longtermoutcomesoftwofirstgenerationtrabecularmicrobypassstentsistentwithphacoemulsificationinprimaryopenangleglaucomaeightyearresults AT paulharasymowycz longtermoutcomesoftwofirstgenerationtrabecularmicrobypassstentsistentwithphacoemulsificationinprimaryopenangleglaucomaeightyearresults
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Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results

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