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The iStent trabecular micro-bypass stent: a case series
E Vandewalle1, T Zeyen, I Stalmans
1Department of Ophthalmology, University Hospitals Leuven, Leuven, B-3000, Belgium.
Purpose:
To evaluate the safety and effectiveness of a trabecular micro-bypass stent, the iStent (Glaukos, USA), for reduction of intraocular pressure in patients with open angle glaucoma.
Methods:
In this prospective case series, ten eyes of eight patients underwent a gonioscopically-guided implantation of an iStent. Six eyes underwent combined surgery: cataract surgery followed by iStent implantation, and the remaining four eyes underwent iStent implantation only. The primary outcome measure was intraocular pressure and the secondary outcome measures were the reduction in number of glaucoma medications, and the number of complications.
Results:
Mean intraocular pressure dropped from 19.6 mmHg preoperatively to 16.3 mmHg (range 12-27) after one month (p = 0.04), to 15.4 mmHg (range 8-23) after six months (p = 0.03) and 15.8 mmHg (range 9-25 mmHg) after one year (p = 0.03). There was a significant reduction in number of hypotensive medications between baseline and 12 months postoperatively from 2.7 to 1.7 medications. No vision-threatening complications were observed.
Conclusions:
The Glaukos iStent trabecular micro-bypass implantation is a safe procedure that is not associated with complications traditionally associated with filtering surgery. This trabecular bypass results in significant mid-term reduction of intraocular pressure as well as the number of medications.