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Is the trabecular micro-bypass a Schlemm's canal surgery? Study with anterior segment spectral domain optical coherence tomography

Session Details

Session Title: Special Issues

Session Date/Time: Friday 15/02/2013 | 08:30-10:00

Paper Time: 08:42

Venue: Hall 2

First Author: : A.Santos PORTUGAL

Co Author(s): :    L. Vieira   M. Lisboa   S. Ferreira   J. Ferreira   J. Cunha  

Abstract Details


To evaluate the role of anterior segment (AS) spectral domain optical coherence tomography (OCT) in locating the trabecular micro-bypass (iStent®) and to access an eventual relationship between the position of this device and its hypotensive efficacy.


Department of Ophthalmology of Centro Hospitalar de Lisboa Central.


In a total of 17 eyes of 17 patients who underwent phacoemulsification combined with iStent® one year before, we studied the irido-corneal angle with spectral domain AS-OCT (Heidelberg Spectralis®) and performed an ophthalmic evaluation including intraocular pressure (IOP) measurement with Goldmann tonometer and gonioscopy.


In all eyes we could locate the iStent® in the angle, but only 4 seemed to be implanted the Schlemm's canal, the other were in the trabecular meshwork or scleral spur. In the 4 eyes with the implant in the canal there was a mean reduction in IOP of 6.0 mmHg in comparison to the preoperative values, in the remaining eyes the mean reduction was 5.36 mmHg. This difference is not statistically significant (p>0.05).


AS spectral domain OCT is an efficient method to determine the position of the iStent® in the angle. Although most distal ends of the devices were not in the Schlemm’s canal, these have overcome the resistance of the trabecular meshwork. Thus its location does not appear to compromise the hypotensive efficacy.

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