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The iStent trabecular micro-bypass stent reduces post-cataract surgery IOP spikes in advanced glaucoma

Poster Details

First Author: M.Kutubi UK

Co Author(s):    P. Pandey   G. Moussa   M. Rana   I. Masood     

Abstract Details



Purpose:

We present data, which demonstrate that the iStent is extremely useful in blunting the post-operative IOP spike following cataract surgery in moderate to advanced glaucoma.

Setting:

Birmingham and Midland eye centre, Birmingham, UK

Methods:

A non-comparative case series where data was collected prospectively on patients with moderate to advanced glaucomatous optic neuropathy. 45 consecutive cases were identified (17 female, 28 male, Mean age 75 years). 11 had advanced glaucoma. Following routine clear corneal temporal section phacoemulsification followed by implantation of 1-2 iStents depending on the target IOP in the nasal quadrant Schlemm canal. IOP readings were checked 2 hours post operatively and then 24 hours post operatively. All patients were prescribed a stat dose of Diamox 250mg immediately after surgery.

Results:

The mean IOP pre-operatively was 23 mmHg. IOP's measured 2 hour and 24 hour post-operatively were 17.97 and 15.5 mmHg respectively. There were no complications or significant spikes in IOP Percentage of patients with 2 hour post op IOP < 15 mmHg, 49% IOP <21 mmHg, 62%. IOP < 25 mmHg, 71%. IOP <30 mmHg, 88%. IOP < 35 mmHg 100%

Conclusions:

The majority of patients did not suffer a significant IOP spike. This was despite borderline IOP in a number of patients with vulnerable optic discs. In the past many of these patients would have required combined cataract and filtering surgery but now they can be managed successfully with iStent implantation at the time of cataract surgery, a procedure with an extremely favourable risk profile. The Istent may have great value in managing such complex cases. FINANCIAL INTEREST: One of more of the authors... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented

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