Phacoemulsification combined with a new ab interno gel stent to treat open-angle glaucoma: Pilot study.
OBJECTIVE
To study the effect on intraocular pressure (IOP) of implanting a new gelatin stent at the time of cataract surgery in the treatment of open-angle glaucoma (OAG).


METHODS
Multicenter university and private-practice settings.


METHODS
Nonrandomized prospective clinical trial.


METHODS
The implantation of 2 models of a gelatin stent (Xen140 and Xen63) was performed at the time of cataract surgery without mitomycin-C. Complete success was defined as a postoperative IOP of less than 18 mm Hg and more than a 20% reduction in IOP at 12 months without glaucoma medication. Failure was defined as loss of light perception vision or worse, a need for additional glaucoma surgery, or less than a 20% reduction in the IOP from baseline.


RESULTS
The study included 37 eyes of 37 patients. The mean preoperative IOP was 22.4 mm Hg ± 4.2 (SD) on 2.5 ± 1.4 medication classes. Twelve months postoperatively, the mean IOP was reduced to 15.4 ± 3.0 mm Hg on 0.9 ± 1.0 medication classes (P < .0001). This resulted in a qualified success of 85.3% and a complete success rate off medications of 47.1%. There were no failures.


CONCLUSIONS
Cataract surgery combined with implantation of the gelatin stent resulted in a significant reduction in IOP in eyes with OAG.


BACKGROUND
Dr. Sheybani has received travel reimbursement from Aquesys, Inc. Dr. Ahmed is a paid consultant to Aquesys, Inc. No other author has a financial or proprietary interest in any material or method mentioned.
From the Department of Ophthalmology and Visual Sciences (Sheybani), Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA; Department of Ophthalmology (Lenzhofer, Hohensinn, Reitsamer), University Clinic Salzburg/SALK and Paracelsus Medical University (Reitsamer), Salzburg, Austria; Department of Ophthalmology and Vision Sciences (Ahmed), University of Toronto, Toronto, Credit Valley Eye Care (Ahmed), and Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada.
Arsham
A
Sheybani
From the Department of Ophthalmology and Visual Sciences (Sheybani), Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA; Department of Ophthalmology (Lenzhofer, Hohensinn, Reitsamer), University Clinic Salzburg/SALK and Paracelsus Medical University (Reitsamer), Salzburg, Austria; Department of Ophthalmology and Vision Sciences (Ahmed), University of Toronto, Toronto, Credit Valley Eye Care (Ahmed), and Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada.
Markus
M
Lenzhofer
From the Department of Ophthalmology and Visual Sciences (Sheybani), Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA; Department of Ophthalmology (Lenzhofer, Hohensinn, Reitsamer), University Clinic Salzburg/SALK and Paracelsus Medical University (Reitsamer), Salzburg, Austria; Department of Ophthalmology and Vision Sciences (Ahmed), University of Toronto, Toronto, Credit Valley Eye Care (Ahmed), and Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada.
Melchior
M
Hohensinn
From the Department of Ophthalmology and Visual Sciences (Sheybani), Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA; Department of Ophthalmology (Lenzhofer, Hohensinn, Reitsamer), University Clinic Salzburg/SALK and Paracelsus Medical University (Reitsamer), Salzburg, Austria; Department of Ophthalmology and Vision Sciences (Ahmed), University of Toronto, Toronto, Credit Valley Eye Care (Ahmed), and Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada.
Herbert
H
Reitsamer
From the Department of Ophthalmology and Visual Sciences (Sheybani), Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA; Department of Ophthalmology (Lenzhofer, Hohensinn, Reitsamer), University Clinic Salzburg/SALK and Paracelsus Medical University (Reitsamer), Salzburg, Austria; Department of Ophthalmology and Vision Sciences (Ahmed), University of Toronto, Toronto, Credit Valley Eye Care (Ahmed), and Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada. Electronic address: ikeahmed@mac.com.
Iqbal Ike K
II
Ahmed
D000368:Aged; D005260:Female; D005780:Gelatin; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D015607:Stents; D014065:Tonometry, Ocular
D005780:Gelatin