Efficacy of Two Trabecular Micro-bypass Stents During Phacoemulsification for Mild to Advanced Primary Open-angle Glaucoma Controlled with Topical Hypotensive Medications

PURPOSE: The purpose of the current study was to evaluate the efficacy and adverse event profile of 2 trabecular micro-bypass stents implanted during standard phacoemulsification cataract surgery in patients with mild to advanced open-angle glaucoma whose intraocular pressure (IOP) was well controlled by topical medications. PATIENTS AND METHODS: This study was a retrospective analysis of patients with mild to advanced chronic open-angle glaucoma who underwent phacoemulsification and implantation of 2 stents. For all patients, preoperative and postoperative characteristics were evaluated, including number of medications and IOP. Postoperative visits were scheduled at 7 days and at months 1, 6, 12, and 24 after surgery. At each visit, IOP and the number of medications were noted. RESULTS: In total, 63 eyes of 41 patients were included in the study. The vast majority of eyes (85.7%) were diagnosed with primary open-angle glaucoma. Preoperative mean IOP at baseline was 16.8±3.0 mm Hg (range, 10 to 24 mm Hg) with a mean of 2.3±0.9 medications. The mean IOP reduction represented a 13% decrease at 1 month (P<0.001), 13% at 6 months (P<0.001), 12% at 1 year (P<0.001), and 10% at 2 years (P<0.001), concomitant with a 23% reduction in the mean number of medications (P<0.001), 35% (P<0.001), 40% (P<0.001), and 40% (P<0.001), respectively, at each scheduled follow-up visit. At 24 months postoperatively, 19 of 23 (83%) patients experienced an IOP decrease compared with the preoperative visit. No severe device-related adverse events were observed. CONCLUSIONS: Patients with mild to advanced glaucoma can benefit from micro-bypass implantation even if their IOP is well controlled with topical hypotensive medications. Expectations for these reductions should be moderate.