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First Author: A.Jünemann GERMANY
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The intraocular pressure (IOP) lowering effect of an ab interno suprachoroidal stent in conjunction with postoperative Travoprost was assessed in open angle glaucoma (OAG) subjects with IOP previously not controlled on two topical hypotensive medications.
The intraocular pressure (IOP) lowering effect of an ab interno suprachoroidal stent in conjunction with postoperative Travoprost was assessed in open angle glaucoma (OAG) subjects with IOP previously not controlled on two topical hypotensive medications
A suprachoroidal stent (Model G3) was developed by Glaukos to create a patent lumen from the anterior chamber into the suprachoroidal space to enhance aqueous outflow and reduce IOP in moderate to advanced OAG. In this prospective trial by the MIGS Study Group, 73 qualified subjects were implanted with a single stent through a 1 mm temporal clear corneal incision under topical anesthesia. Preoperative medicated IOP was required to be between 18 mmHg and 30 mmHg on two medications. Preoperative IOP after medication washout was required to be between 22 mmHg and 38 mmHg. Travoprost was prescribed postoperatively and discontinued if IOP measured below 6 mmHg. Postoperative evaluations occurred at Day 1, Week 1, and Month 1, 3, 6, 12, 13, 18, 24 and 25.
Mean preoperative medicated diurnal IOP was 20.4 mmHg (SD 2.4), and unmedicated (baseline) IOP was 24.8 mmHg (SD 1.7). To date, forty-two subjects have been followed through 12 months postoperative. Following uncomplicated implantation of a Model G3 suprachoroidal stent and administration of postoperative Travoprost, IOP decreased to 13.2 mmHg or less through the one year timeframe. Ninety-eight percent of eyes with follow-up through one year met the primary efficacy endpoint of IOP reduction ? 20% with reduction in one medication. IOP reduction in the remaining subject was 18.2%. All eyes met the secondary efficacy endpoint of IOP ? 18 mmHg with reduction of one medication; 90% achieved IOP ? 15 mmHg with reduction of one medication. No untoward postoperative sequelae have been observed to date. BCVA improved or maintained from preoperative BCVA in 40 of 42 subjects.
These data through 12 months postoperative suggest that MIGS implantation of a suprachoroidal stent in OAG subjects previously uncontrolled on two topical hypotensive medications is feasible, safe and capable of significant reduction in IOP and medication burden.