Official ESCRS | European Society of Cataract & Refractive Surgeons
Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Reduced IOP and medication burden through 30 months: prospective, randomized, comparative study in OAG patients of implantation of 1, 2 or 3 trabecular micro-bypass stents as a sole procedure

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Session Details

Session Title: Glaucoma II

Session Date/Time: Monday 12/09/2016 | 08:00-10:30

Paper Time: 08:00

Venue: Hall C4

First Author: : A.Fea ITALY

Co Author(s): :                        

Abstract Details


Previous clinical work has demonstrated benefit of multiple vs. single trabecular bypass as a standalone procedure for additive intraocular pressure (IOP) lowering through 18 months. In this same study by the Micro-Invasive Glaucoma Surgery (MIGS) Study Group, we evaluated outcomes through 30 months (M30) following implantation of 1, 2 or 3 stents as a sole procedure in open angle glaucoma (OAG) subjects preoperative ocular hypotensive medications.


The MIGS Study Group is comprised of surgeons visiting from eight countries and staff surgeons in Armenia. These visiting and staff surgeons have performed surgeries at one investigational site – the S.V. Malayan Ophthalmological Center in Yerevan, Armenia


This prospective, randomized study enrolled subjects with OAG on preoperative medication who were willing and able to be followed through 5 years postoperative. Subjects were required to have medicated IOP ≥ 18 mmHg and ≤ 30 mmHg, discontinue their medications, and return for evaluation of unmedicated IOP. Eyes with unmedicated IOP ≥ 22 mmHg and ≤ 38 mmHg were then randomized (1:1:1) to implantation of 1 stent (n=38), 2 stent (n=41) or 3 stent (n=40). Of 119 subjects, 117 have been followed 30 months. Medication burden, IOP, CD ratio, visual field, BCVA, pachymetry, and intraoperative/postoperative adverse events were evaluated.


Preoperative mean medicated IOP was 19.8 mmHg (SD 1.3), 20.1 mmHg (SD 1.6) and 20.4 mmHg (SD 1.8) in 1, 2 and 3-stent eyes, respectively. After medication washout, mean preoperative IOP was 25.0 mmHg (SD 1.2), 25.0 mmHg (SD 1.7) and 24.9 mmHg (SD 2.2) in the 3 respective groups. Mean IOP was 15.2 mmHg (SD 2.6), 15.0 mmHg (SD 1.3) and 13.4 (SD 1.4) mmHg at M30 in the 3 groups; 10 of the 1-stent eyes, 4 of 2-stent and 3 of 3-stent eyes required medication. Five eyes among the groups underwent cataract surgery.


Both IOP and medication use were reduced after implantation of a single trabecular micro-bypass stent as a sole procedure in OAG. Additional IOP reduction to ≤ 15 mmHg has been shown with multiple stents. Favorable safety was reported in all eyes. These findings demonstrate sustained titratable efficacy of trabecular micro-bypass through 30 months, with safe outcomes using 1 or multiple stents.

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