Tarun Sharma
Worcestershire Acute Hospitals NHS Trust, UK
Title: Trabectomevs I-stent in moderate open-angle glaucoma-single surgeon results
Biography
Biography: Tarun Sharma
Abstract
Aim: To compare the safety and efficacy profile after combined micro-incision cataract surgery (MICS) and micro-invasive glaucoma surgery (MIGS) with the ab interno trabeculectomy (Trabectome®) versus iStent® inject devices in patients with open-angle glaucoma (OAG) and cataract.
Method: This retrospective comparison study included 60 eyes which were treated with combined MICS and ab interno trabeculectomy (group I, Trabectome®) (30 eyes) and iStent® inject devices (group II, GTS 400) in 30 eyes. Primary outcome measures included intraocular pressure (IOP) and glaucoma medication after 6 weeks, 3, 6 and 12 months follow-up. Secondary outcome measures were number of postoperative interventions, complications and best-corrected visual acuity (BCVA).
Results: Mean preoperative IOP decreased from 23.3±3.7 mmHg in group I and 22.8±4.1 mmHg in group II to 14.8±3.6 mmHg
for trabectome and 16.8±2.3 mmHg for iStent inject, respectively at 12 months after surgery. When percentage drop was assessed,
group 1 (trabectome) had 37.17% drop in IOP, while group II had 22.93% drop in IOP. No vision-threatening complications such
as choroidal effusion, choroidal hemorrhage, or infection occurred. In each group, 2 eyes developed cystoid macular edema which
responded to topical treatment. In each group trabeculectomy had to be performed in one eye due to insufficient IOP lowering effect.
Conclusions: Ab interno trabeculectomy and iStent® inject were both effective in lowering IOP with a favorable and comparable
safety profile in a comparative study over a 12-months follow-up in OAG. Trabectome appears to have a greater percent drop in
IOP than iStent in this study. However, longer follow-up of these patients will be necessary to determine long-term outcomes and to
evaluate significant differences.