title: Prospective evaluation of microinvasive glaucoma surgery with trabecular microbypass stents and prostaglandin in open-angle glaucoma.
abstract: OBJECTIVE
  To evaluate the intraocular pressure (IOP) lowering effect of 2 trabecular microbypass stents and postoperative travoprost in patients with open-angle glaucoma (OAG) not controlled on 2 medications preoperatively.
  
  
  METHODS
  S.V. Malayan Ophthalmology Centre, Yerevan, Armenia.
  
  
  METHODS
  Prospective open-label nonrandomized study.
  
  
  METHODS
  This prospective pilot study involved 39 qualified phakic patients with OAG, medicated IOP between 18 mm Hg and 30 mm Hg, and unmedicated baseline (after washout) IOP between 22 mm Hg and 38 mm Hg. Patients received 2 stents (iStent) through a clear corneal incision and were prescribed travoprost starting the night of postoperative day 1. Intraocular pressure, complications, and various safety measures were assessed at examinations through 18 months and planned for every 6 months thereafter until month 60. A washout of medications was performed 13 months postoperatively.
  
  
  RESULTS
  All patients achieved an IOP reduction of 20% or more from baseline to 12 months with reduction of 1 medication and with IOP 18 mm Hg or less. Follow-up through 18 months showed that medicated IOP decreased from 22.2 mm Hg ± 2.0 (SD) on 2 medications preoperatively to 14 mm Hg or less on 1 medication at the postoperative visits. The mean unmedicated IOP decreased from 25.3 ± 1.8 mm Hg preoperatively to 17.1 ± 2.2 mm Hg 13 months postoperatively. No intraoperative or serious device-related adverse events occurred.
  
  
  CONCLUSIONS
  Patients with OAG treated with 2 trabecular microbypass stents and 1 presumptive postoperative medication achieved a significant and sustained reduction in IOP and medication through 18 months.
  
  
  BACKGROUND
  Dr. Katz served as the medical monitor for this study. All authors are consultants to Glaukos Corp.
authors.affiliation: From the University of Toronto (Ahmed), Toronto, Ontario, Canada; the Wills Eye Hospital (Katz), Jefferson Medical College, Philadelphia, Pennsylvania, the Altos Eye Physicians (Chang), Los Altos, California, the Ophthalmic Consultants of Long Island (Donnenfeld), Rockville Centre, New York, the Carolina Eyecare Physicians (Solomon), Mt. Pleasant, South Carolina, and the Minnesota Eye Consultants (Samuelson), Minneapolis, Minnesota, USA; the S.V. Malayan Ophthalmology Centre (Voskanyan), Yerevan, Armenia. Electronic address: ike.ahmed@utoronto.ca.
authors.forename: Iqbal Ike K
authors.initials: II
authors.lastname: Ahmed
authors.affiliation: From the University of Toronto (Ahmed), Toronto, Ontario, Canada; the Wills Eye Hospital (Katz), Jefferson Medical College, Philadelphia, Pennsylvania, the Altos Eye Physicians (Chang), Los Altos, California, the Ophthalmic Consultants of Long Island (Donnenfeld), Rockville Centre, New York, the Carolina Eyecare Physicians (Solomon), Mt. Pleasant, South Carolina, and the Minnesota Eye Consultants (Samuelson), Minneapolis, Minnesota, USA; the S.V. Malayan Ophthalmology Centre (Voskanyan), Yerevan, Armenia.
authors.forename: L Jay
authors.initials: LJ
authors.lastname: Katz
authors.affiliation: From the University of Toronto (Ahmed), Toronto, Ontario, Canada; the Wills Eye Hospital (Katz), Jefferson Medical College, Philadelphia, Pennsylvania, the Altos Eye Physicians (Chang), Los Altos, California, the Ophthalmic Consultants of Long Island (Donnenfeld), Rockville Centre, New York, the Carolina Eyecare Physicians (Solomon), Mt. Pleasant, South Carolina, and the Minnesota Eye Consultants (Samuelson), Minneapolis, Minnesota, USA; the S.V. Malayan Ophthalmology Centre (Voskanyan), Yerevan, Armenia.
authors.forename: David F
authors.initials: DF
authors.lastname: Chang
authors.affiliation: From the University of Toronto (Ahmed), Toronto, Ontario, Canada; the Wills Eye Hospital (Katz), Jefferson Medical College, Philadelphia, Pennsylvania, the Altos Eye Physicians (Chang), Los Altos, California, the Ophthalmic Consultants of Long Island (Donnenfeld), Rockville Centre, New York, the Carolina Eyecare Physicians (Solomon), Mt. Pleasant, South Carolina, and the Minnesota Eye Consultants (Samuelson), Minneapolis, Minnesota, USA; the S.V. Malayan Ophthalmology Centre (Voskanyan), Yerevan, Armenia.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Donnenfeld
authors.affiliation: From the University of Toronto (Ahmed), Toronto, Ontario, Canada; the Wills Eye Hospital (Katz), Jefferson Medical College, Philadelphia, Pennsylvania, the Altos Eye Physicians (Chang), Los Altos, California, the Ophthalmic Consultants of Long Island (Donnenfeld), Rockville Centre, New York, the Carolina Eyecare Physicians (Solomon), Mt. Pleasant, South Carolina, and the Minnesota Eye Consultants (Samuelson), Minneapolis, Minnesota, USA; the S.V. Malayan Ophthalmology Centre (Voskanyan), Yerevan, Armenia.
authors.forename: Kerry D
authors.initials: KD
authors.lastname: Solomon
authors.affiliation: From the University of Toronto (Ahmed), Toronto, Ontario, Canada; the Wills Eye Hospital (Katz), Jefferson Medical College, Philadelphia, Pennsylvania, the Altos Eye Physicians (Chang), Los Altos, California, the Ophthalmic Consultants of Long Island (Donnenfeld), Rockville Centre, New York, the Carolina Eyecare Physicians (Solomon), Mt. Pleasant, South Carolina, and the Minnesota Eye Consultants (Samuelson), Minneapolis, Minnesota, USA; the S.V. Malayan Ophthalmology Centre (Voskanyan), Yerevan, Armenia.
authors.forename: Lilit
authors.initials: L
authors.lastname: Voskanyan
authors.affiliation: From the University of Toronto (Ahmed), Toronto, Ontario, Canada; the Wills Eye Hospital (Katz), Jefferson Medical College, Philadelphia, Pennsylvania, the Altos Eye Physicians (Chang), Los Altos, California, the Ophthalmic Consultants of Long Island (Donnenfeld), Rockville Centre, New York, the Carolina Eyecare Physicians (Solomon), Mt. Pleasant, South Carolina, and the Minnesota Eye Consultants (Samuelson), Minneapolis, Minnesota, USA; the S.V. Malayan Ophthalmology Centre (Voskanyan), Yerevan, Armenia.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Samuelson
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001082:Aqueous Humor / Q000502:physiology; D003008:Cloprostenol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D063171:Corneal Pachymetry; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D015607:Stents; D014065:Tonometry, Ocular; D014129:Trabecular Meshwork / Q000601:surgery*; D000069557:Travoprost; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents; D003008:Cloprostenol; D000069557:Travoprost