Purpose:

To investigate the long-term safety and efficacy of a trabecular microbypass stent (iStent) combined with cataract surgery in patients with pseudoexfoliative glaucoma (PXG)

Methods:

Retrospective, consecutive case series from September 2012 to December 2015. Data was collected pre-operatively, and post-operatively out to 7 years postoperative. Primary outcome measures included intraocular pressure (IOP) and number of glaucoma medications. Safety was assessed by noting the incidence of post-operative IOP pressure spikes ≥15 mmHg and need for additional surgery.

Results:

The series included 117 eyes. The mean preoperative IOP was 20.5 ± 6.6 mm Hg. At 7 years postoperative, mean IOP was 15.0 ± 5.0 mmHg (p<0.001). the="" mean="" number="" of="" glaucoma="" medications="" was="" 1.4="" ±="" 1.0="" pre-operatively="" and="" 1.3="" ±="" 1.0="" 7="" years="" after="" surgery.="" 94%="" of="" eyes="" with="" a="" baseline="" iop="" of="" 18="" mmhg="" or="" greater="" achieved="" a="" reduction="" in="" iop.="" postoperatively,="" 5%="" of="" eyes="" had="" iop="" increases="" ≥15="" mmhg="" above="" their="" baseline="" iop="" and="" 5="" eyes="" underwent="" additional="" surgery.="" the="" mean="" number="" of="" glaucoma="" medications="" was="" 1.4="" ±="" 1.0="" pre-operatively="" and="" 1.3="" ±="" 1.0="" 7="" years="" after="" surgery.="" 94%="" of="" eyes="" with="" a="" baseline="" iop="" of="" 18="" mmhg="" or="" greater="" achieved="" a="" reduction="" in="" iop.="" postoperatively,="" 5%="" of="" eyes="" had="" iop="" increases="" ≥15="" mmhg="" above="" their="" baseline="" iop="" and="" 5="" eyes="" underwent="" additional="">

Conclusions:

The insertion of 1 trabecular micro-bypass stent with cataract extraction provides a sustained IOP (>5 mmHg) reduction out to 7 years after surgery in eyes with PXG. Eyes with a higher baseline IOP achieved a more robust pressure reduction.