THE ISTENTt TRABECULAR MICRO-BYPASS STENT: A CASE

Purpose: To evaluate the safety and effectiveness of a trabecular micro-bypass stent, the iStentTM (Glau-kos, 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-guid-ed implantation of an iStentTM. Six eyes underwent combined surgery: cataract surgery followed by iS-tentTM implantation, and the remaining four eyes un-derwent iStentTM implantation only. The primary out-come measure was intraocular pressure and the se-condary 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 hy-potensive medications between baseline and 12 months postoperatively from 2.7 to 1.7 medica-tions. No vision-threatening complications were ob-served. Conclusions: The Glaukost iStent trabecular micro-bypass implantation is a safe procedure that is not associated with complications traditionally associ-ated with filtering surgery. This trabecular bypass re-sults in significant mid-term reduction of intraocu-lar pressure as well as the number of medications. KEY WORDS glaucoma, intraocular pressure, iStent, trabecular bypass. zzzzz