Reoperation after MIGS most often due to problems with IOP, gel microstents

Elevated intraocular pressure (IOP) and problems with gel microstents were the main cause of reoperation within the first 90 days after minimally invasive glaucoma surgery (MIGS), according to a study.

In this retrospective case series, a total of 448 MIGS procedures, including trabecular microbypass stents (n = 206), gel microstents (n = 152), and goniotomy procedures (n = 90), performed on 348 patients (436 eyes) were included. Combined phacoemulsification occurred in 58.7% of eyes.

Within 90 days of MIGS, reoperation took place in 5.3% (n = 23) of eyes, with 10.5%, 2.0%, and 3.3% occurring in the gel microstent group, in iStent/iStent inject group, and the goniotomy group, respectively.

Indications for reoperation included elevated IOP, gel microstent tip exposure with wound leakage, and early gel microstent encapsulation without elevated IOP in 69.6%, 13%, and 4.3%, of eyes, respectively. Reoperation for lens complications was required for 8.7% of eyes and elevated IOP and aphakia requiring reoperation for 4.3% of eyes.

The authors concluded that within the first 90 days after MIGS, reoperation rates were low.

Reference

Shalaby WS, Bechay J, Myers J, et al. Reoperation for complications within 90 days of minimally invasive glaucoma surgery. J Cataract Refract Surg. 2020;DOI: 10.1097/j.jcrs.0000000000000545. Epub ahead of print. PMID: 33315736.