Results for the Synergy trial: use of iStent in open angle glaucoma

• Published in: Acta ophthalmologica (Oxford, England) England), 2016-10, Vol.94 (S256), p.n/a
• Main Authors: Garcia‐Feijoo, J., Voskanyan, L., Martinez de la Casa, J.M.
• Format: Article
• Language: English
• Subjects: Anesthesia; Appointments & personnel changes; Glaucoma; Implants; Medical treatment; Ophthalmology; Surgery; Titanium
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2016.0189

Summary iStent aim to improve access of aqueous to Schlemm's canal and to the collector channels. IStent surgery can be performed on topical and intracamerular anaesthesia. The G1 Glaukos® trabecular micro‐bypass is L‐shaped titanium implant. iStent inject is conic and smaller than the G1and also made of titanium. The Stents are pre‐loaded in the injector designed to deliver the stents into the Schlemm′s canal. For iStent inject Voskanyan et al (2014) conducted a multicenter study on 99 POAG patients uncontrolled on two or more topical medications. 66% of subjects achieved IOP ≤ 18 mmHg at 12 months without medication, and 81% of subjects achieved Month 12 IOP ≤ 18 mmHg with either a single medication or no medication. Mean baseline washout IOP values decreased by 10.2 mmHg or 39.7% from 26.3 (SD 3.5) mmHg to 15.7 (SD 3.7) mmHg at Month 12. Mean IOP at 12 months was 14.7 (SD 3.1) mmHg in subjects not using ocular hypotensive medications. The best indications for the trabecular stent are cases with primary open angle, pigmentary or PSX glaucoma. The ideal candidate for this surgery is a patient with early or moderate glaucoma, patients with compliance issues, bad tolerance to medical treatment or reluctant towards a chronic daily treatment.