Trabecular microbypass stent implantation with cataract extraction in pseudoexfoliation glaucoma

Abstract

Purpose To evaluate the safety and efficacy of a trabecular microbypass stent (iStent) combined with cataract surgery in patients with pseudoexfoliation glaucoma (PXG). Setting Vance Thompson Vision, Sioux Falls, South Dakota, USA. Design Retrospective case series. Methods Eyes with PXG had implantation of 1 stent. Data were collected preoperatively and postoperatively through 24 months. Data included intraocular pressure (IOP), number of glaucoma medications, the incidence of postoperative IOP pressure spikes of 15 mm Hg or higher at any timepoint, and the need for additional surgery. Results The series included 115 eyes. The mean preoperative IOP was 20.00 mm Hg ± 6.95 (SD). One year postoperatively, the mean IOP was 15.54 ± 3.83 mm Hg (P < .01). At 2 years, the mean IOP was 14.51 ± 2.79 (P < .01). The mean number of glaucoma medications was 1.41 ± 1.04 preoperatively and 0.71 ± 0.94 2 years postoperatively (P < .01), indicating a 50% reduction in medication use. Postoperatively, 7 eyes (6%) had an IOP spike of 15 mm Hg or higher above the baseline IOP; the spikes responded to topical therapy. Ninety-eight percent of patients with an IOP of 20 mm Hg or higher achieved a reduction in IOP at the last follow-up. Conclusion Trabecular microbypass stent implantation during cataract surgery safely and effectively lowered IOP and medication use in patients with mild to severe PXG.