Purpose:

To evaluate the long-term safety and efficacy of a trabecular microbypass stent combined with cataract surgery in patients with primary open-angle glaucoma (POAG)

Methods:

Retrospective, consecutive case series from April 2012 to December 2015. The series was comprised of 406 eyes implanted with a trabecular microbypass stent with concomitant cataract surgery. Data was collected pre-operatively, and post-operatively at 1 day, 1 week, months 1, 3, 6, 12 out to 6 years after surgery. Primary outcome measures included intraocular pressure and number of glaucoma medications. Safety measures included pressure increases ≥15 mmHg above baseline and the need for additional surgery.

Results:

Prior to the surgery, baseline values were a mean IOP of 18.8 ± 5.6 and mean no. of medications of 1.4 ± 1.1. 5 years after surgery, the mean IOP was 14.6 ± 3.5 and mean no. of medications was reduced to 1.2 ± 0.9. This reduction was sustained out to 6 years with a mean IOP of 14.8 ± 3.5 and 1.2 ± 1.0. In eyes with baseline IOP ≥18 mmHg and 1+ medications, IOP reduction was >5 mmHg and medication reduction was >20%. 5% of eyes had IOP spikes ≥15 mmHg and 14 eyes required additional surgery.

Conclusions:

The insertion of 1 trabecular microbypass stent with cataract extraction provides long-term reduction in both pressure and medication use in open-angle glaucoma. The magnitude of IOP reduction is more significant in patients with higher preoperative pressure. The safety profile of the procedure is excellent.