Turkish Abstract Abstract PDF Similar Articles Mail to Author

¹Beyoğlu Göz Eğitim Araştırma Hastanesi Klinik Şef. Yard., İstanbul, Doç. Dr.
²Beyoğlu Göz Eğitim Araştırma Hastanesi Klinik Şefi, İstanbul, Prof. Dr.
³Beyoğlu Göz Eğitim Araştırma Hastanesi, İstanbul, Asist. Dr.
⁴Beyoğlu Göz Eğitim Araştırma Hastanesi Klinik Şef Yard., İstanbul, Uzm. Dr.
⁵Derince Askeri Hastanesi, İzmit, Uzm. Dr. Purpose: To investigate the safety and effectiveness of Trabecular Bypass Micro Stent (GlaukosTM i-stent) in open-angle glaucoma patients via a prospective, controlled study.
Materials and Methods: The study was carried out in three groups. In the first group, one or two stents was/were randomly inserted into 23 medically uncontrolled, open-angle glaucoma patients. In the second group, either two stents were applied or latanoprost therapy was started in 21 newly diagnosed open-angle glaucoma patients randomly. In the third group, either phaco+stent or only phaco surgery was performed in 12 cataract patients with openangle glaucoma. Surgery was performed under local anesthesia. An L-shaped stent, preloaded onto a special inserter was put into the anterior chamber through a temporal clear corneal incision with a 20 G MVR knife. The stent was inserted into the Schlemm’s canal using a Swan Jacob surgical goniolens. The changes in the number of antiglaucomatous medications and intraocular pressure (IOP) were analyzed.
Results: In patients with one stent, the preoperative mean IOP dropped from 20.7±2.4 mmHg with a mean number of 1.7±1.2 drugs to 18.7± 2.5 mmHg with 0.7±1.3 drugs, whereas in patients with two stents, the preoperative mean IOP dropped from 21.1±2.2 mmHg with 2.0±0.9 drugs to 18.7±1.8 mmHg with 0.8±1.0 drugs. The decrease in both IOP and the number of drugs was statistically significant within each subgroup, but the difference between the two subgroups was not significant (one stent versus two stents). Mean baseline IOP in the latanaprost group was 22.9 ±3.3 mmHg and it decreased to 17.6±2.7 mmHg in the last examination. Furthermore, the preoperative mean IOP in patients with two stents was 23.5±1.5 mmHg and it decreased to 17.8±2.9 mmHg in the last examination. The decrease in IOP was not different between the two subgroups (latanaprost versus two stents). In the phaco group, the preoperative mean IOP dropped from 22.9±4.7 mmHg with a mean number of 0.6±0.9 drugs to 16.4±1.8 mmHg with 0.8±1.1 drugs, whereas, in the phaco+stent group, it dropped from 23.1±4.9 mmHg with a mean number of 0.6±0.5 drugs to 14.6±2.8 mmHg without any drug in the last control. The decrease in IOP was statistically significant in both subgroups. The phaco+stent combined procedure allowed discontinuation of antiglaucomatous drugs in all patients. An IOP spike was seen only in one case on the first postoperative day. Minimal anterior chamber hemorrhage was detected in only 4 eyes. Refractive and visual acuity changes were not detected in any patient except in those who underwent phaco surgery.
Conclusion: Glaukos i-stent was safe and effective in open-angle glaucoma treatment. Keywords : Open-angle glaucoma, trabecular bypass stent