Zachary Vest, MD, of Mile High Eye Institute, spoke with Ophthalmology 360 at the 2026 ASCRS Annual Meeting about his study that assessed phacoemulsification with a third-generation micro-bypass device. At 2 years, they found positive efficacy and safety outcomes.
Zachary Vest, MD:
My name is Dr. Zachary Vest. I practice at the Mile High Eye Institute in Denver, Colorado. We presented our data on our 2-year outcomes of phacoemulsification with a third-generation micro-bypass device or iStent infinite. In our constant cohort of 27 eyes, at 2 years, we found there was a starting intraocular pressure of 16 that decreased to 4 years at that 2-year mark. There was an overall increase in the number of patients that achieved an IOP below 12, 15, and 18 compared to their starting pressures, including approximately 93% of patients that achieved a pressure below 18. In terms of medication burden, we had approximately a drop in a quarter on average to start. At that 2-year mark, the average was approximately 0.75 number of medications. There was a decrease in medication burden as well.
Overall, looking at the safety profile, so we looked at those 27 patients for IOP and medication analysis, but there were 5 patients outside of those 27 patients that needed secondary interventions. Those interventions included 4 cases of SLT and 1 case of repeat iStent infinite implantation. Overall, at 2 years, there was good efficacy in terms of IOP lowering, medication decrease, and a good safety profile with a low chance of needing secondary interventions.
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