Third-Generation Trabecular Micro-Bypass Implantation and Phacoemulsification in Patients with Glaucoma: A...

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Medical Device Technology

Background:

• Glaucoma management often requires multiple medications and surgical interventions.
• Trabecular micro-bypass devices offer a minimally invasive approach to reduce intraocular pressure (IOP).
• Third-generation devices aim to improve efficacy and safety in glaucoma treatment.

Purpose of the Study:

• To evaluate the effectiveness and safety of the third-generation iStent infinite trabecular micro-bypass implantation combined with phacoemulsification.
• To assess changes in intraocular pressure (IOP) and topical medication usage over 12 months.
• To determine the proportion of patients achieving target IOP levels and medication independence.

Main Methods:

• A multicenter study involving 233 eyes undergoing iStent infinite implantation and phacoemulsification.
• Key outcomes measured included mean IOP, number of medications, and proportions achieving specific IOP goals (≤18/15/12 mmHg).
• Data analyzed for a consistent cohort (n=96) with 12-month follow-up.

Main Results:

• Mean IOP reduced from 17.2 mmHg to 13.8 mmHg (p=0.001) at 12 months.
• Mean medication use decreased from 1.24 to 0.61 (p=0.001).
• Proportions achieving IOP ≤18/15/12 mmHg increased significantly, and medication-free eyes rose from 16.7% to 62.5% (p=0.001).

Conclusions:

• iStent infinite combined with phacoemulsification demonstrates significant IOP reduction and decreased medication burden.
• The procedure is effective in achieving target IOP and improving medication independence in glaucoma patients.
• This combination therapy offers a clinically relevant, real-world solution for glaucoma management.