Three-year outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic population with primary open-angle glaucoma

Mark J Gallardo,1,2 Richard A Supnet11El Paso Eye Surgeons, PA, El Paso, TX, USA; 2Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USAPurpose: To present long-term, real-world outcomes after implanting one trabecular micro-bypass stent with cat...

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Autores principales:	Gallardo MJ, Supnet RA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	glaucoma trabecular micro-bypass Hispanic micro-invasive glaucoma surgery IOP long term iStent Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/ffd38bfb2e1945e1886584e3af727178
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spelling	oai:doaj.org-article:ffd38bfb2e1945e1886584e3af7271782021-12-02T05:56:21ZThree-year outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic population with primary open-angle glaucoma1177-5483https://doaj.org/article/ffd38bfb2e1945e1886584e3af7271782019-05-01T00:00:00Zhttps://www.dovepress.com/three-year-outcomes-of-combined-trabecular-micro-bypass-and-phacoemuls-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Mark J Gallardo,1,2 Richard A Supnet11El Paso Eye Surgeons, PA, El Paso, TX, USA; 2Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USAPurpose: To present long-term, real-world outcomes after implanting one trabecular micro-bypass stent with cataract surgery for primary open-angle glaucoma (POAG) in a predominantly Hispanic patient population.Patients and methods: This retrospective, consecutive case series evaluated intraocular pressure (IOP), medications, and safety through 36 months after implanting one iStent®, during phacoemulsification cataract surgery. Eyes were stratified into 2 subgroups classified by preoperative IOP and surgical goal. The Controlled Group had IOP <18 mmHg on ≥1 medications, and goal to reduce medications. The Uncontrolled Group had IOP ≥18 mmHg and/or maximum tolerated medication load, and goal to reduce IOP. Assessments included IOP, medications, visual fields (VF), retinal nerve fiber layer thickness (RNFL), adverse events, and secondary surgeries.Results: Of 168 total operated eyes, 87 eyes (49 Controlled, 38 Uncontrolled) completed 36 months of follow-up and comprise the Consistent Cohort in this report. At baseline, 79.6% (39/49) of Controlled eyes and 71.1% (27/38) of Uncontrolled eyes were from Hispanic patients. In the Controlled Group desiring medication reduction, mean medications were reduced by 77.3% (2.6 medications preoperatively vs 0.6 at 36 months; p<0.001. All Controlled eyes maintained or reduced medications versus preoperative; no eyes were on ≥3 medications (vs 61.2% preoperatively); and 58.3% were medication-free (vs 0% preoperatively). In the Uncontrolled Group desiring IOP reduction, mean IOP decreased by 31.2% (19.4 mmHg preoperatively vs 13.4 mmHg at 36 months; p<0.001), 91.7% of eyes achieved IOP ≤18 mmHg, 69.4% reached IOP ≤15 mmHg, and 77.8% decreased IOP ≥20% vs baseline. Uncontrolled eyes also experienced a 45.3% medication reduction (2.2 medications preoperatively vs 1.2 at 36 months; p<0.001). Favorable safety included no intraoperative complications, and stable VF and RNFL through 36 months.Conclusion: In this predominantly Hispanic patient cohort, significant IOP and medication reductions were sustained safely through 36 months after iStent implantation during cataract surgery.Keywords: glaucoma, trabecular micro-bypass, Hispanic, micro-invasive glaucoma surgery, IOP, long term, iStent®Gallardo MJSupnet RADove Medical Pressarticleglaucomatrabecular micro-bypassHispanicmicro-invasive glaucoma surgeryIOPlong termiStentOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 869-879 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	glaucoma trabecular micro-bypass Hispanic micro-invasive glaucoma surgery IOP long term iStent Ophthalmology RE1-994
spellingShingle	glaucoma trabecular micro-bypass Hispanic micro-invasive glaucoma surgery IOP long term iStent Ophthalmology RE1-994 Gallardo MJ Supnet RA Three-year outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic population with primary open-angle glaucoma
description	Mark J Gallardo,1,2 Richard A Supnet11El Paso Eye Surgeons, PA, El Paso, TX, USA; 2Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USAPurpose: To present long-term, real-world outcomes after implanting one trabecular micro-bypass stent with cataract surgery for primary open-angle glaucoma (POAG) in a predominantly Hispanic patient population.Patients and methods: This retrospective, consecutive case series evaluated intraocular pressure (IOP), medications, and safety through 36 months after implanting one iStent®, during phacoemulsification cataract surgery. Eyes were stratified into 2 subgroups classified by preoperative IOP and surgical goal. The Controlled Group had IOP <18 mmHg on ≥1 medications, and goal to reduce medications. The Uncontrolled Group had IOP ≥18 mmHg and/or maximum tolerated medication load, and goal to reduce IOP. Assessments included IOP, medications, visual fields (VF), retinal nerve fiber layer thickness (RNFL), adverse events, and secondary surgeries.Results: Of 168 total operated eyes, 87 eyes (49 Controlled, 38 Uncontrolled) completed 36 months of follow-up and comprise the Consistent Cohort in this report. At baseline, 79.6% (39/49) of Controlled eyes and 71.1% (27/38) of Uncontrolled eyes were from Hispanic patients. In the Controlled Group desiring medication reduction, mean medications were reduced by 77.3% (2.6 medications preoperatively vs 0.6 at 36 months; p<0.001. All Controlled eyes maintained or reduced medications versus preoperative; no eyes were on ≥3 medications (vs 61.2% preoperatively); and 58.3% were medication-free (vs 0% preoperatively). In the Uncontrolled Group desiring IOP reduction, mean IOP decreased by 31.2% (19.4 mmHg preoperatively vs 13.4 mmHg at 36 months; p<0.001), 91.7% of eyes achieved IOP ≤18 mmHg, 69.4% reached IOP ≤15 mmHg, and 77.8% decreased IOP ≥20% vs baseline. Uncontrolled eyes also experienced a 45.3% medication reduction (2.2 medications preoperatively vs 1.2 at 36 months; p<0.001). Favorable safety included no intraoperative complications, and stable VF and RNFL through 36 months.Conclusion: In this predominantly Hispanic patient cohort, significant IOP and medication reductions were sustained safely through 36 months after iStent implantation during cataract surgery.Keywords: glaucoma, trabecular micro-bypass, Hispanic, micro-invasive glaucoma surgery, IOP, long term, iStent®
format	article
author	Gallardo MJ Supnet RA
author_facet	Gallardo MJ Supnet RA
author_sort	Gallardo MJ
title	Three-year outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic population with primary open-angle glaucoma
title_short	Three-year outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic population with primary open-angle glaucoma
title_full	Three-year outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic population with primary open-angle glaucoma
title_fullStr	Three-year outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic population with primary open-angle glaucoma
title_full_unstemmed	Three-year outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic population with primary open-angle glaucoma
title_sort	three-year outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly hispanic population with primary open-angle glaucoma
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/ffd38bfb2e1945e1886584e3af727178
work_keys_str_mv	AT gallardomj threeyearoutcomesofcombinedtrabecularmicrobypassandphacoemulsificationinapredominantlyhispanicpopulationwithprimaryopenangleglaucoma AT supnetra threeyearoutcomesofcombinedtrabecularmicrobypassandphacoemulsificationinapredominantlyhispanicpopulationwithprimaryopenangleglaucoma
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Three-year outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic population with primary open-angle glaucoma

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