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Using multiple trabecular micro-bypass stents in cataract patients to treat open-angle glaucoma

Research Authors
Graham W. Belovay, MD, Abdulla Naqi, MD, Brian J. Chan, MD, Mahmoud Rateb, MD, Iqbal Ike K. Ahmed, MD
Research Department
Research Journal
Journal of Cataract and Refractive Surgery
Research Member
Research Publisher
LWW
Research Rank
1
Research Vol
38(11)
Research Website
http://www.jcrsjournal.org/
Research Year
2012
Research_Pages
1911-1917
Research Abstract

PURPOSE: To evaluate the efficacy of multiple trabecular micro-bypass stents combined with cataract surgery in patients with open-angle glaucoma (OAG) and cataract.
SETTING: Private practice, Mississauga, Ontario, Canada.
DESIGN: Comparative case series.
METHODS: Eyes with OAG had implantation of 2 or 3 micro-bypass stents with concurrent cataract surgery and follow-up through 1 year. Efficacy measures were intraocular pressure (IOP) and topical ocular hypotensive medication use. Safety assessment included complications and corrected distance visual acuity (CDVA).
RESULTS: The study comprised 53 eyes (47 patients); 28 had implantation of 2 stents and 25 had implantation of 3 stents. The overall mean 1-year postoperative IOP was 14.3 mm Hg, which was significantly lower than preoperative IOP overall and in each group (P<.001). The target IOP was achieved in a significantly higher proportion of eyes at 1 year versus preoperatively (77% versus 43%; P<.001). Overall, 83% of eyes had a decrease in topical ocular hypotensive medication at 1 year from preoperatively, with a 74% decrease in the mean number of medications (from 2.7 to 0.7) at 1 year (P<.001). The 3-stent group was on significantly fewer medications than the 2-stent group at 1 year (0.4 versus 1.0; PZ.04).
CONCLUSIONS: Using multiple micro-bypass stents with concurrent cataract surgery led to a mean postoperative IOP of less than 15 mm Hg and allowed patients to achieve target pressure control with significantly fewer medications through 1 year.