Cataract Surgery Plus Trabecular Meshwork Bypass Stents Improves Ocular Surface Disease
Cataract surgery in conjunction with a trabecular meshwork bypass stents (iStent) improved ocular surface disease, according to a study presented at the American Society of Cataract and Refractive Surgery (ASCRS) Virtual Annual Meeting.
In this prospective trial, data from 50 patients who underwent cataract surgery in combination with iStent or iStent inject trabecular meshwork bypass stent, were analyzed. Patients saw improvements in Ocular Surface Disease Index, fluorescein tear break-up time, corneal/conjunctival staining (Oxford Grading Scale), and conjunctival hyperemia (Efron Scale).
Researchers noted that patients experienced a reduction in the number of glaucoma medications taken preoperatively. Intraocular pressure also decreased in patients.
In a second, long-term pivotal randomized controlled trial, iStent inject in combination with phacoemulsification had similar corneal endothelial safety as phacoemulsification alone, according to data presented at the ASCRS Paper Sessions.
In this study, 135 patients were treated with iStent inject in combination with phacoemulsification and 40 patients with just phacoemulsification. Endothelial cell density (ECD) and endothelial cell loss (ECL) >30% from baseline was assessed over 3 years.
At follow-up, mean central ECD percentage and ECL >30% were similar between the groups.
In patients with IOP ≥25 mmHg and patients with no prostaglandin use at screening, those in the combination treatment group were more likely to participate in the patient reported outcome follow-up visits of 2 years. There was a 10% difference in the percentage of patient reported outcome responders between the groups, which the researchers considered to be “clinically meaningful.”
Reference
Barrtman BJ, et al. Ocular surface disease improvement in eyes implanted with trabecular meshwork bypass stents. American Society of Cataract and Refractive Surgery (ASCRS) Virtual Annual Meeting. May 16, 2020.
Samuelson TW, et al. Long-term safety and patient reported outcomes on 2nd generation trabecular micro-bypass stent system. American Society of Cataract and Refractive Surgery (ASCRS) Virtual Annual Meeting. May 16, 2020.
