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Contralateral eye comparison study in MICS & MIGS: Trabectome® vs. iStent inject®.

Johannes Gonnermann1, Eckart Bertelmann2, Milena Pahlitzsch2

  • 1Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. johannes.gonnermann@gmx.de.

Graefe'S Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie
|November 6, 2016
PubMed
Summary
This summary is machine-generated.

Ab interno trabeculectomy and iStent® inject effectively lowered intraocular pressure (IOP) in open-angle glaucoma patients. Both micro-invasive glaucoma surgery (MIGS) procedures demonstrated comparable safety and efficacy over 12 months.

Keywords:
MIGSTrabectomeTrabecular micro-bypassab interno trabeculectomyiStent inject

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Cataract Surgery

Background:

  • Open-angle glaucoma (OAG) and cataracts often coexist, requiring combined surgical approaches.
  • Micro-invasive glaucoma surgery (MIGS) offers a less invasive alternative to traditional glaucoma procedures.
  • Evaluating novel MIGS devices alongside established techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To compare the safety and efficacy of ab interno trabeculectomy (Trabectome®) versus two iStent® inject devices in patients with OAG and cataracts.
  • To assess intraocular pressure (IOP) reduction and medication needs after combined micro-incision cataract surgery (MICS) and MIGS.
  • To evaluate postoperative complications and visual acuity following these combined procedures.

Main Methods:

  • A retrospective, intraindividual eye comparison study involving 27 patients (54 eyes).
  • One eye received combined MICS and ab interno trabeculectomy (Trabectome®), while the contralateral eye received two iStent® inject devices.
  • Primary outcomes included IOP and glaucoma medication use at 6 weeks, 3, 6, and 12 months; secondary outcomes included interventions, complications, and best-corrected visual acuity (BCVA).

Main Results:

  • Both Trabectome® and iStent® inject significantly reduced preoperative IOP at 12 months (Trabectome®: 22.3 to 15.6 mmHg; iStent® inject: 21.3 to 14.0 mmHg).
  • No significant difference in IOP reduction was observed between the two MIGS groups (p > 0.05).
  • No vision-threatening complications occurred; two eyes in each group required subsequent trabeculectomy for insufficient IOP control.

Conclusions:

  • Ab interno trabeculectomy and iStent® inject are effective for IOP lowering in OAG patients undergoing cataract surgery.
  • Both procedures exhibit favorable and comparable safety profiles over a 12-month follow-up.
  • Longer-term studies are needed to ascertain definitive outcomes and potential differences between these MIGS techniques.