Outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic patient population

Mark J Gallardo,1,2 Richard A Supnet,1 Jane Ellen Giamporcaro,3 Dana M Hornbeak3 1El Paso Eye Surgeons, PA, El Paso, 2Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 3Division of Clinical Research and Medical Affairs, Glaukos Corporation, Lagun...

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Autores principales:	Gallardo MJ, Supnet RA, Giamporcaro JE, Hornbeak DM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	glaucoma trabecular micro-bypass Hispanic MIGS IOP Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/41c753f8f5574b6ea18080cfd6fc6f47
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spelling	oai:doaj.org-article:41c753f8f5574b6ea18080cfd6fc6f472021-12-02T00:17:36ZOutcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic patient population1177-5483https://doaj.org/article/41c753f8f5574b6ea18080cfd6fc6f472016-10-01T00:00:00Zhttps://www.dovepress.com/outcomes-of-combined-trabecular-micro-bypass-and-phacoemulsification-i-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Mark J Gallardo,1,2 Richard A Supnet,1 Jane Ellen Giamporcaro,3 Dana M Hornbeak3 1El Paso Eye Surgeons, PA, El Paso, 2Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 3Division of Clinical Research and Medical Affairs, Glaukos Corporation, Laguna Hills, CA, USA Purpose: The purpose of this study was to evaluate intraocular pressure (IOP) and topical ocular hypotensive medication burden at 12 months postoperatively in a predominantly Hispanic patient population with primary open-angle glaucoma each implanted with one trabecular micro-bypass stent during cataract surgery.Methods: This was a retrospective, consecutive case series. The main objective was to assess reduction of IOP and/or medication burden in all eyes at the 12-month postoperative exam. A secondary objective was to assess outcomes in 3 subgroups, distinguished preoperatively by IOP control and by medication burden (suboptimal or maximum therapy) and with different treatment goals. Group 1 had medication-controlled IOP and goal to reduce medications while maintaining IOP control (n=65); Group 2 had uncontrolled IOP on ≤2 medications and goal to reduce IOP and maintain/reduce medication burden (n=31); and Group 3 had uncontrolled IOP on ≥3 medications and goal to reduce IOP and avoid filtering surgery (n=38). Evaluations included IOP, medication use, cup-to-disc ratio, visual fields, complications, and interventions. One hundred subjects (134 eyes) have been followed for 12 months.Results: Most patients (80%) were Hispanic and had moderate or severe glaucoma (87%). At 12 months, mean IOP reduced to 12.9 mmHg vs 16.5 mmHg preoperatively; 92% had an IOP ≤15 mmHg at 12 months (99% had ≤18 mmHg). Mean medication burden had decreased to 0.9 vs 2.3 preoperatively. At the 12-month time point, 94% of all eyes achieved their predefined treatment goal of reduced IOP and/or medications. Reductions in medication burden for Group 1, and in IOP for Groups 2 and 3, were highly statistically significant (P<0.001). Two eyes in Group 3 had filtering surgery; the remaining 95% avoided such treatment. No other complications were reported.Conclusion: This mainly Hispanic population with predominantly moderate or severe glaucoma had substantial reduction of IOP and medication and favorable safety for 12 months following stent implantation during cataract surgery, with treatment success achieved in all 3 subgroups. These data show this stent technology to be effective in Hispanic eyes with more advanced disease. Keywords: glaucoma, trabecular micro-bypass, Hispanic, micro-invasive glaucoma surgery, IOPGallardo MJSupnet RAGiamporcaro JEHornbeak DMDove Medical Pressarticleglaucomatrabecular micro-bypassHispanicMIGSIOPOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 10, Pp 1931-1937 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	glaucoma trabecular micro-bypass Hispanic MIGS IOP Ophthalmology RE1-994
spellingShingle	glaucoma trabecular micro-bypass Hispanic MIGS IOP Ophthalmology RE1-994 Gallardo MJ Supnet RA Giamporcaro JE Hornbeak DM Outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic patient population
description	Mark J Gallardo,1,2 Richard A Supnet,1 Jane Ellen Giamporcaro,3 Dana M Hornbeak3 1El Paso Eye Surgeons, PA, El Paso, 2Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 3Division of Clinical Research and Medical Affairs, Glaukos Corporation, Laguna Hills, CA, USA Purpose: The purpose of this study was to evaluate intraocular pressure (IOP) and topical ocular hypotensive medication burden at 12 months postoperatively in a predominantly Hispanic patient population with primary open-angle glaucoma each implanted with one trabecular micro-bypass stent during cataract surgery.Methods: This was a retrospective, consecutive case series. The main objective was to assess reduction of IOP and/or medication burden in all eyes at the 12-month postoperative exam. A secondary objective was to assess outcomes in 3 subgroups, distinguished preoperatively by IOP control and by medication burden (suboptimal or maximum therapy) and with different treatment goals. Group 1 had medication-controlled IOP and goal to reduce medications while maintaining IOP control (n=65); Group 2 had uncontrolled IOP on ≤2 medications and goal to reduce IOP and maintain/reduce medication burden (n=31); and Group 3 had uncontrolled IOP on ≥3 medications and goal to reduce IOP and avoid filtering surgery (n=38). Evaluations included IOP, medication use, cup-to-disc ratio, visual fields, complications, and interventions. One hundred subjects (134 eyes) have been followed for 12 months.Results: Most patients (80%) were Hispanic and had moderate or severe glaucoma (87%). At 12 months, mean IOP reduced to 12.9 mmHg vs 16.5 mmHg preoperatively; 92% had an IOP ≤15 mmHg at 12 months (99% had ≤18 mmHg). Mean medication burden had decreased to 0.9 vs 2.3 preoperatively. At the 12-month time point, 94% of all eyes achieved their predefined treatment goal of reduced IOP and/or medications. Reductions in medication burden for Group 1, and in IOP for Groups 2 and 3, were highly statistically significant (P<0.001). Two eyes in Group 3 had filtering surgery; the remaining 95% avoided such treatment. No other complications were reported.Conclusion: This mainly Hispanic population with predominantly moderate or severe glaucoma had substantial reduction of IOP and medication and favorable safety for 12 months following stent implantation during cataract surgery, with treatment success achieved in all 3 subgroups. These data show this stent technology to be effective in Hispanic eyes with more advanced disease. Keywords: glaucoma, trabecular micro-bypass, Hispanic, micro-invasive glaucoma surgery, IOP
format	article
author	Gallardo MJ Supnet RA Giamporcaro JE Hornbeak DM
author_facet	Gallardo MJ Supnet RA Giamporcaro JE Hornbeak DM
author_sort	Gallardo MJ
title	Outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic patient population
title_short	Outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic patient population
title_full	Outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic patient population
title_fullStr	Outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic patient population
title_full_unstemmed	Outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic patient population
title_sort	outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly hispanic patient population
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/41c753f8f5574b6ea18080cfd6fc6f47
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Outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic patient population

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