The iStent trabecular micro-bypass stent: a case series.
OBJECTIVE
To evaluate the safety and effectiveness of a trabecular micro-bypass stent, the iStent (Glaukos, USA), for reduction of intraocular pressure in patients with open angle glaucoma.


METHODS
In this prospective case series, ten eyes of eight patients underwent a gonioscopically-guided implantation of an iStent. Six eyes underwent combined surgery: cataract surgery followed by iStent implantation, and the remaining four eyes underwent iStent implantation only. The primary outcome measure was intraocular pressure and the secondary outcome measures were the reduction in number of glaucoma medications, and the number of complications.


RESULTS
Mean intraocular pressure dropped from 19.6 mmHg preoperatively to 16.3 mmHg (range 12-27) after one month (p = 0.04), to 15.4 mmHg (range 8-23) after six months (p = 0.03) and 15.8 mmHg (range 9-25 mmHg) after one year (p = 0.03). There was a significant reduction in number of hypotensive medications between baseline and 12 months postoperatively from 2.7 to 1.7 medications. No vision-threatening complications were observed.


CONCLUSIONS
The Glaukos iStent trabecular micro-bypass implantation is a safe procedure that is not associated with complications traditionally associated with filtering surgery. This trabecular bypass results in significant mid-term reduction of intraocular pressure as well as the number of medications.
Vandewalle
E
E
Department of Ophthalmology, University Hospitals Leuven, Leuven, B-3000, Belgium.
Zeyen
T
T
Stalmans
I
I
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D004869:Equipment Safety; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents; D016896:Treatment Outcome