7-year efficacy and safety of iStent inject trabecular micro-bypass in combined and standalone usage

• Verfasst von: Hengerer, Fritz [VerfasserIn]
• Verfasst von: Auffarth, Gerd U. [VerfasserIn]
• Verfasst von: Conrad-Hengerer, Ina [VerfasserIn]
• Titel: 7-year efficacy and safety of iStent inject trabecular micro-bypass in combined and standalone usage
• Verf.angabe: Fritz H. Hengerer, Gerd U. Auffarth, Ina Conrad-Hengerer
• E-Jahr: 2024
• Jahr: 16 February 2024
• Umfang: 19 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 28.05.2024 ; Im Titel ist "inject" schräg gestellt
• Titel Quelle: Enthalten in: Advances in therapy
• Ort Quelle: Tarporley : Springer Healthcare Communications, 2000
• Jahr Quelle: 2024
• Band/Heft Quelle: 41(2024), 4, Seite 1462-1480
• ISSN Quelle: 1865-8652
• DOI: doi:10.1007/s12325-024-02788-y
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Cataract
• Sach-SW: CATARACT-EXTRACTION
• Sach-SW: Intraocular pressure
• Sach-SW: INTRAOCULAR-PRESSURE
• Sach-SW: iStent inject
• Sach-SW: LENS IMPLANTATION
• Sach-SW: Long-term
• Sach-SW: MICROBYPASS STENT IMPLANTATION
• Sach-SW: Microinvasive glaucoma surgery (MIGS)
• Sach-SW: OPEN-ANGLE GLAUCOMA
• Sach-SW: OUTCOMES
• Sach-SW: PHACOEMULSIFICATION
• Sach-SW: QUALITY-OF-LIFE
• Sach-SW: REDUCTION
• Sach-SW: Second-generation
• Sach-SW: Stent
• Sach-SW: Trabecular bypass
• Sach-SW: TRIAL
• K10plus-PPN: 1890126365

Abstract

Introduction: This study evaluated 7-year effectiveness and safety of second-generation trabecular micro-bypass implantation (iStent inject) either in combination with cataract surgery or as a standalone procedure (Combined or Standalone subgroups, respectively) in eyes with open-angle glaucoma. Methods: This prospective, non-randomized, unmasked, longitudinal study included 125 consecutive iStent inject cases of a single surgeon at a large German academic hospital. Patients had considerable preoperative disease burden, with mean intraocular pressure (IOP) of 23.5 mmHg, 84.8% of eyes on >= 2 medications, and 38.4% of eyes with prior glaucoma surgery. IOP, medications, adverse events, and secondary surgeries were assessed through 7 years in the Overall cohort and in Combined (n = 81) and Standalone (n = 44) subgroups. Results: Over 7-year follow-up, mean IOP decreased by 36.2-40.0% in Overall eyes, 34.1-38.9% in Combined eyes, and 39.5-43.5% in Standalone eyes (p < 0.001 at all timepoints for all groups). Meanwhile, mean medications decreased by 59.3-71.3% in Overall eyes, 57.9-69.0% in Combined eyes, and 62.1-76.2% in Standalone eyes (p < 0.001 at all timepoints in all groups). At last follow-up (mean 77.4 months; 92.8% of patients with last visit at 6 or 7 years), 83.7% of Overall eyes, 82.3% of Combined eyes, and 86.4% of Standalone eyes had achieved >= 20% IOP reduction vs preoperative. At last follow-up vs preoperative, 100% of eyes in all groups had the same or lower IOP and 100% had the same or lower medication regimen. Safety outcomes were favorable, with no filtration surgeries and only 4.84% of eyes experiencing clinically significant visual field loss over 7 years of follow-up. Conclusion: iStent inject implantation with or without phacoemulsification produced significant and durable 7-year reductions in IOP (similar to 34-44% reduction) and medications (similar to 58-76% reduction) while preventing filtering surgery in this cohort of patients with relatively high preoperative disease burden. Combined and Standalone cases had similarly favorable effectiveness and safety.