The STARflo™ glaucoma implant: a single-centre experience at 24 months

To evaluate the 24-month outcomes following STARflo™ implantation in patients with moderate or advanced open-angle glaucoma.

We enrolled 32 patients (40 eyes) with high intraocular pressure (IOP) resistant to topical and systemic medical therapy. After baseline assessments, patients were implanted with STARflo™ implants with the goal of IOP reduction and long-term maintenance. Patients were followed for 24 months. Complete success of implantation was defined as a restoration of normal IOP without topical glaucoma medications, while qualified success was defined as a restoration of normal IOP with implantation and topical glaucoma medications.

STARflo™ did not satisfactorily reduce IOP at 24 months. Twenty-eight eyes (70%) had elevated IOP at least once during the 24 months post-implantation period. Five eyes (12.5%) developed corneal decompensation. The average IOP 24 months after the surgery was 13.42 ± 6.03 mmHg and was not significantly different than IOP at 12 months (13.2 ± 5.59 mmHg). Moreover, 45% of treated eyes needed additional glaucoma procedures after 1 year and 2 years to achieve these IOPs. STARflo™ did reduce the average number of topical glaucoma medications from 2.7 pre-implantation to 1.17 at 24 months postoperatively in the rest 55% of the eyes.

The STARflo™ implantation did not meet success criteria and so appears to be an ineffective alternative to filtering surgical procedures for patients with treatment-refractory open-angle glaucoma.