Phacoemulsification versus phacoemulsification with micro-bypass stent implantation in primary open-angle glaucoma: Randomized double-masked clinical trial
Presented as a poster at the annual meeting of the American Academy of Ophthalmology, Atlanta, Georgia, USA, November 2008.
Received 31 March 2009; received in revised form 30 September 2009; accepted 1 October 2009.
Purpose
To compare phacoemulsification alone and phacoemulsification with micro-bypass stent implantation in eyes with primary open-angle glaucoma.
Setting
Instituto di Fisiopatologia Clinica, Clinica Oculistica, Universita' di Torino, Torino, Italy.
Methods
In this prospective double-masked randomized clinical trial, patients had phacoemulsification alone (control group) or phacoemulsification with iStent implantation (combined group). Primary outcomes were intraocular pressure (IOP) and reduction in medication use over 15 months and IOP after a 1-month washout of ocular hypotensive agents (ie, 16 months postoperatively).
Results
The baseline IOP was similar between groups (combined group: 17.9 mm Hg ± 2.6 [SD]; control group: 17.3 ± 3.0 mm Hg) (P = .512). Three patients in the control group were lost to follow-up. The mean IOP was 14.8 ± 1.2 mm Hg in the combined group and 15.7 ± 1.1 mm Hg in the control group at 15 months and 16.6 ± 3.1 mm Hg and 19.2 ± 3.5 mm Hg, respectively, after washout; the IOP was statistically significantly lower in the combined group than in the control group at both time points (P = .031 and P = .042, respectively). At 15 months, the mean number of medications was lower in the combined group than in the control group (0.4 ± 0.7 and 1.3 ± 1.0, respectively; P = .007), as was the proportion of patients on ocular hypotensive medication (33% and 76%, respectively).
Conclusions
Phacoemulsification with stent implantation was more effective in controlling IOP than phacoemulsification alone; the safety profiles were similar.
Financial Disclosure
The author has no financial or proprietary interest in any material or method mentioned.
From Instituto di Fisiopatologia Clinica, Clinica Oculistica, Universita' di Torino, Torino, Italy
Corresponding author: Antonio Fea, MD, Instituto di Fisiopatologia Clinica, Clinica Oculistica, Universita' di Torino, Via Juvarra 19, 10100 Torino, Italy.
Study devices were provided by Glaukos Corp., Laguna Hills, California, USA.
Supported by Ricerca Finalizzata della Regione Piemonte 2007.
IMEDS, Inc., provided biostatistical and medical writing expertise. F. Machetta, MD, and G.M. Vizzeri, MD, provided patients.
ABSTRACT