Third-Generation Trabecular Micro-Bypass Implantation and Phacoemulsification in Patients with Glaucoma: A Multicenter Study

TL;DR

A study found that combining a new glaucoma implant with cataract surgery significantly lowers eye pressure and reduces medication use.

Contribution

Demonstrates real-world effectiveness of third-generation trabecular micro-bypass implantation combined with phacoemulsification in glaucoma patients.

Findings

Intraocular pressure decreased significantly from 17.2 to 13.8 mmHg at 12 months.

The proportion of patients off glaucoma medications increased from 16.7% to 62.5%.

More than 90% of patients achieved an intraocular pressure of ≤18 mmHg after 12 months.

Abstract

This multicenter study evaluated the effectiveness and safety of third-generation trabecular micro-bypass implantation (iStent® infinite) combined with phacoemulsification (n = 233 eyes). Key outcomes through 12 months included the mean change in intraocular pressure (IOP) and the number of topical medications, as well as proportions achieving IOPs ≤ 18/15/12 mmHg or using 0/1/2/ ≥ 3 medications. In all eyes with 12-month follow-up data (n = 96, consistent cohort), the mean IOP reduced from 17.2 ± 4.2 mmHg preoperatively to 13.8 ± 3.0 mmHg at Month 12 (p = 0.001), while the mean number of medications reduced from 1.24 ± 0.91 preoperatively to 0.61 ± 0.96 at Month 12 (p = 0.001). The proportions of eyes achieving IOP ≤ 18/15/12 mmHg increased from 63.5%, 34.4%, and 14.6% preoperatively to 92.7%, 71.9%, and 37.5%, respectively at Month 12, (all p = 0.001). The proportions of eyes off medication increased from 16.7% preoperatively to 62.5% at Month 12 (p = 0.001). This study provides clinically relevant, real-world results that demonstrate significant reductions in IOP and the number of topical glaucoma medications required following iStent infinite trabecular micro-bypass and phacoemulsification.

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