Early Outcomes After Third-Generation Trabecular Micro-Bypass With/Without Goniotomy In Eyes With Failed Prior Glaucoma Intervention

The newest trabecular MIGS device, iStent infinite trabecular micro-bypass, contains three stents that can be implanted in a standalone procedure or in combination with phacoemulsification or other MIGS procedures. The current study evaluated consecutive standalone cases of a single surgeon in patients who had failed prior laser trabeculoplasty.

Private ophthalmology practice in the United States.

This retrospective, non-randomized, unmasked study included 14 eyes of 9 patients with mild to severe open-angle glaucoma who underwent iStent infinite implantation with or without iAccess Precision Blade goniotomy in one U.S. glaucoma private practice. IOP, meds, adverse events, and secondary surgeries were evaluated preoperatively and through 6 months of follow-up. Twelve-month data will be available by the time of the conference.

All patients were pseudophakic and had undergone at least one prior laser trabeculoplasty. All were successfully implanted with three iStent infinite stents with no intraoperative
complications. In 36% of eyes (5/14), goniotomy (iAccess Precision Blade) was also completed. Mean IOP reduced from 21.6±3.0mmHg preoperatively to 16.8±2.6mmHg at 6 months (22% reduction, p=0.135); mean medications reduced from 1.1±0.4 preoperatively to 0.2±0.4 meds at 6 months (82% reduction; p=0.013). No postoperative adverse events or secondary surgeries occurred.

iStent infinite implantation with or without iAccess goniotomy yielded 6-month reductions in intraocular pressure and a significant reduction in medication burden in patients with failed prior laser trabeculoplasty, with favorable safety.