title: Using multiple trabecular micro-bypass stents in cataract patients to treat open-angle glaucoma.
abstract: OBJECTIVE
  To evaluate the efficacy of multiple trabecular micro-bypass stents combined with cataract surgery in patients with open-angle glaucoma (OAG) and cataract.
  
  
  METHODS
  Private practice, Mississauga, Ontario, Canada.
  
  
  METHODS
  Comparative case series.
  
  
  METHODS
  Eyes with OAG had implantation of 2 or 3 micro-bypass stents with concurrent cataract surgery and follow-up through 1 year. Efficacy measures were intraocular pressure (IOP) and topical ocular hypotensive medication use. Safety assessment included complications and corrected distance visual acuity (CDVA).
  
  
  RESULTS
  The study comprised 53 eyes (47 patients); 28 had implantation of 2 stents and 25 had implantation of 3 stents. The overall mean 1-year postoperative IOP was 14.3 mm Hg, which was significantly lower than preoperative IOP overall and in each group (P<.001). The target IOP was achieved in a significantly higher proportion of eyes at 1 year versus preoperatively (77% versus 43%; P<.001). Overall, 83% of eyes had a decrease in topical ocular hypotensive medication at 1 year from preoperatively, with a 74% decrease in the mean number of medications (from 2.7 to 0.7) at 1 year (P<.001). The 3-stent group was on significantly fewer medications than the 2-stent group at 1 year (0.4 versus 1.0; P=.04).
  
  
  CONCLUSIONS
  Using multiple micro-bypass stents with concurrent cataract surgery led to a mean postoperative IOP of less than 15 mm Hg and allowed patients to achieve target pressure control with significantly fewer medications through 1 year.
  
  
  BACKGROUND
  Dr. Ahmed is a consultant to Glaukos Corp. No other author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Graham W
authors.initials: GW
authors.lastname: Belovay
authors.forename: Abdulla
authors.initials: A
authors.lastname: Naqi
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Chan
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Rateb
authors.forename: Iqbal Ike K
authors.initials: II
authors.lastname: Ahmed
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002386:Cataract / Q000150:complications*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D032801:Iridectomy; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D011446:Prospective Studies; D015607:Stents; D014065:Tonometry, Ocular; D014130:Trabeculectomy; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents