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Master Thesis

Registry Study of Two Trabecular Micro-bypass iStents° Implantation Combined With Cataract Surgery in Various Glaucoma Types and Severities: Long-term Real-life Outcomes

Abstract : Purpose: to assess the long-term efficacy and safety of two trabecular micro-bypass iStents° implantation with concomitant cataract surgery in a real-life setting. Methods: registry study performed at Bordeaux University Hospital including patients with various subtypes and severities of glaucoma, who underwent phacoemulsification followed by ab interno gonioscopically guided implantation of 2 iStents° between November 2010 and December 2017. Postoperatively, subjects were assessed on day 3, 15, month 1, 3, 6, 12, and then every 6 months for a period of 4 years follow-up. IOP (tonometry), number of medications and complications were assessed at each visit. Association of baseline characteristics with failure of the procedure was evaluated in a multivariate analysis. Results: 138 eyes of 91 subjects were included in the analysis. The mean follow-up was 31.8 +/- 16.2 months. Mean baseline IOP was 18.01+/-5.39 mmHg with a mean number of 2.3+/-1.1 hypotensive medications. 59.4% of eyes at 1 year and 53.9% at 3 years achieved an IOP reduction of ≥20% from baseline or an IOP ≤18mmHg with a reduction of at least 1 medication. Among these eyes, the mean IOP reduction was 22.6% at 1 year with a 76% decrease in the number of medications; and was stable over time with a mean 22.3% IOP reduction at the last follow-up visit and the number of medications reduced by 72%. 84.13% (n=53) of these eyes were medication-free at one month and 70.37% (n=38) at one year. There were no serious adverse events related to the device; frequently reported events included transient IOP spikes (above 30% from baseline); 9 eyes required additional glaucoma surgery. Male gender, thinner RNFL and decreased ACD were significantly associated with failure. Conclusion: this study shows in a real-life setting that cataract surgery with iStents° implantation is a valuable option in mild-to-moderate glaucoma, allowing a decreased medication burden due to a safe and sustained reduction in IOP.
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https://dumas.ccsd.cnrs.fr/dumas-03425014
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Submitted on : Wednesday, November 10, 2021 - 4:53:40 PM
Last modification on : Friday, December 17, 2021 - 3:47:07 AM

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  • HAL Id : dumas-03425014, version 1

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Marine Assoun. Registry Study of Two Trabecular Micro-bypass iStents° Implantation Combined With Cataract Surgery in Various Glaucoma Types and Severities: Long-term Real-life Outcomes. Life Sciences [q-bio]. 2021. ⟨dumas-03425014⟩

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