Eyeworld Daily News

EW SHOW DAILY 58 Meeting Reporter Monday, April 16, 2018 by Rich Daly EyeWorld Contributing Writer two, or three iStents in standalone surgeries. After 54 months, the group had a mean IOP reduction of 32–34% below the unmedicated preop IOP, with little difference between the number of stents received. However, the share of patients in the single-stent group able to maintain IOP reductions of at least 20% without medications fell from 89% at 12 months postop to 61% at 24 months postop. In contrast, the share of two stent recipients with at least a 20% IOP reduction without medications increased from 90% at 12 months postop to 94% at 24 months postop. Similarly, 92% of three stent recip- ients had at least a 20% IOP reduc- tion at 12 months and 91% had it at 24 months. EW Editors' note: Dr. Hovanesian and Dr. Samuelson have financial interests with Glaukos and other companies. T he iStent inject (Glaukos, San Clemente, Califor- nia) continued to provide clinically significant IOP reduction 2 years after implantation, according to newly released study results. In a prospective, randomized, controlled trial comparing two iStent inject devices injected into the trabecular meshwork as well as phacoemulsification to phaco alone found 75.3% in the former group had at least a 20% reduction in di- urnal IOP at 24 months, while only 61.3% achieved that in the latter group. Also at 24 months, the mean unmedicated diurnal IOP reduction was 6.9 mm Hg in the iStent group and 5.4 mm Hg in the phaco only group. iStent inject and phaco achieved a 7.7 mm Hg mean reduction, or a 31% cut, in observed unmedicated diurnal IOP. Also, 62.6% of patients in the iStent inject and phaco group had unmedicated diurnal IOP of 18 mm Hg or less at 24 months, while only 49.2% of phaco-only patients reached that. The medication burden in the iStent inject plus phaco group fell from 1.6 medications preop to 0.4 medications postop. The phaco-only group reduced its number of medica- tions from 1.5 to 0.8 at 23 months postop—twice the number of medi- cations as those in the iStent inject plus phaco group. There were not many differenc- es in the safety results for the two groups, said Thomas Samuelson, MD, Minneapolis. The results echoed findings of significant pressure reductions when more than one stent was used among the 30,000 previous iStent recipients worldwide. Separate research also found that open angle glaucoma (OAG) eyes not controlled on two medi- cations can be successfully treated by the iStent inject and travoprost. The findings came in a prospective single-arm, unmasked trial of the treatment among patients with mild to moderate OAG. The iStent inject stents are deliv- ered through a single-use injector through a clear corneal incision into Schlemm's canal. The mean IOP at 24 months postop was 12.4 mm Hg, or 50% less than the post-washout mean. The study also found that at 36 months postop 87% had IOPs of 15 mm Hg or lower and 91% had IOPs of 18 mm Hg or less. The study found 88% had at least a 20% IOP reduction, compared to their preop IOP on two medica- tions. John Hovanesian, MD, Lagu- na Hills, California, noted that the study found good safety results. A third study found single and multiple iStent implantation as a standalone procedure demonstrated substantial IOP reduction, reduced the patients' medication burden, and achieved an overall favorable safety profile at 54 months post-im- plantation. The study followed 93 OAG patients for 54 months postop who had been randomized to receive one, Study: iStent inject cuts IOP 2 years postop 2018 poster presentations Full-Thickness Scleral Incision Technique to Treat Cyclodialysis Cleft after Cataract Extraction with Microinvasive Glaucoma Surgery Daniela Alvarez-Ascencio, MD, Jesus Jimenez-Roman, MD, Gabriel Lazcano Sr., MD Combined Phacoemulsification, Trabecular Bypass Stenting, and Canaloplasty Versus Combined Phacoemulsification and Trabecular Stenting Alone Jack Parker, MD Retrospective Review of Phacoemulsification Combined with a Suprachoroidal Stent Versus Phacoemulsification Combined with a Trabecular Bypass Stent for the Treatment of POAG Steven Vold, MD, Mike McFarland, OD Trypan Blue-Assisted Microinvasive Glaucoma Surgery Jack Parker, MD, Marius Heersink, BS, Mark Hill, MD, John Parker, MD Histopathologic and Immunohistochemical Analysis of Explanted Corneal Inlays Showing Adherent Fibroconnective Tissue Scar Formation Grace Paley, MD, George J. Harocopos, MD Descemet Membrane Endothelial Keratoplasty Learning Curve for a Single Surgeon without DSAEK Experience: Outcomes in First 500 Consecutive Cases Matthew Feng, MD, Francis Price, MD, Sheila Pabon, MD, Marianne Price, PhD Sensitivity of Low-Cost Photokeratoscope for Use in the Developing World Emma Young, Anam Qureshi, MD, Alexander Bottini, MD Diagnosis of Corneal Graft Rejection Using 3-Dimensional Endothelial Descemet Membrane Optical Tomography Vatookarn Roongpoovapatr, MD, Ibrahim Sayed-Ahmed, MD, Amr Elsawy, PhD, Dan Wen, MD, Mohamed Abdel-Mottaleb, PhD, Sonia Yoo, MD, Mohamed Abou Shousha, MD Corneal Crosslinking Reduces Epithelial Hyperplasia and Myopic Regression after Transepithelial PRK Sun Woong Kim, MD, PhD, David Sung Yong Kang, MD Comparison of Central Vault after Copolymer Phakic IOL Implantation Jin Kwon Chung, MD, PhD Analysis of Impact of Humidity and Temperature on Excimer Laser Ablation of PET, PMMA and Porcine Corneal Tissue Samuel Arba Mosquera, PhD, Shwetabh Verma Changes in Anterior and Posterior Corneal Curvature: Small-Incision Lenticule Extraction Versus LASIK A. John Kanellopoulos, MD Descemetorhexis Versus DMEK for Fuchs Endothelial Corneal Dystrophy Marshall Huang, MD Toxicity of Povidone-Iodine to Ocular Surface of Rabbits Hyun Seung Kim, MD Safety of Intracameral Cefuroxime use in Penicillin-Allergic Patients During Cataract Surgery Madyan Qureshi, BM, BSc Five-Year Outcomes Using Surface- Modified Intraocular Lens Hiroyuki Matsushima, MD Use of Trypan Blue in Assisting Visualization of Anterior Capsule: Safety Analysis Young Min Park, MD, Jong Lee, MD Techniques to Adjust IOP Immediate- ly after Femtosecond-assisted and Microincision Cataract Surgery to Avoid IOP Spike John Jarstad, MD Effectiveness of a Preoperative Risk Scoring Form for Cataract Surgery on Reducing Vitreous Loss Amelia Davidson, MB Chb, BSc, Larry Benjamin, MD Epi-Bowman Blunt Keratectomy Versus Ethyl Alcohol Epithelium Removal in Myopic PRK: Contralateral-Eye Study A. John Kanellopoulos, MD

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