Document Type

Thesis

Title

Long Term Efficacy of a Supraciliary Micro-stent Combined with Cataract Surgery in the Treatment of Glaucoma

Authors

Michael Robert McFarland, Nova Southeastern University

Degree Name

Master of Science (M.S.) in Clinical Vision Research

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Optometry

First Advisor

Bin Zhang

Publication Date / Copyright Date

2019

Publisher

Nova Southeastern University

NSUWorks Citation

Michael Robert McFarland. 2019. Long Term Efficacy of a Supraciliary Micro-stent Combined with Cataract Surgery in the Treatment of Glaucoma. Master's thesis. Nova Southeastern University. Retrieved from NSUWorks, College of Optometry. (14)
https://nsuworks.nova.edu/hpd_opt_stuetd/14.

Abstract

Purpose: The purpose of this study is to evaluate the long-term efficacy of supraciliary micro-stent implantation in combination with phacoemulsification in the treatment of mild-moderate primary open angle glaucoma (POAG). Methods: Retrospective data of patients previously enrolled in the “Study of an Implantable Device for Lowering Intraocular Pressure in Glaucoma Patients Undergoing Cataract Surgery” (COMPASS trial), in which patients with mild-moderate POAG had undergone either cataract surgery alone or cataract surgery combined with implantation of a supraciliary micro-stent, were collected. Eligible patients had since exited the trial and had 5-8 years of postoperative data available. The primary outcome measure was the proportion of eyes with a “complete success” defined as an IOP ≤ 18 mmHg on no glaucoma medications and not having undergone any secondary surgical procedures for IOP control. Thirty-three eyes were in the treatment group and 12 eyes were in the control group. Device safety was also reviewed. Results: Significantly more eyes in the treatment group achieved a “complete success” (61%) versus those eyes in the control group (17%) (p<0.05). When controlling for patient age, sex, preoperative visual field, preoperative IOP, and preoperative anti-glaucoma medication usage, eyes in the treatment groups were 9 times more likely to meet the primary outcome measure versus control group (p=0.004). Mean postoperative IOP was 17.7 ± 4.8 in the control group versus 15.0 ± 4.4 in the treatment group (p=0.08), while mean medication usage was 0.9 ± 0.7 in the control group versus 0.4 ± 0.7 in the treatment group (p=0.01). Average follow up was 6.38 years. No device related adverse events, such as corneal decompensation occurred. Conclusion: Implantation of a supraciliary micro-stent combined with cataract surgery in eyes with mild-moderate POAG demonstrates better long term IOP control than those eyes undergoing cataract surgery alone.

Disciplines

Optometry

Keywords

cataract, glaucoma, intraocular pressure, microstent, MIGS, surgery

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