ASCRS Live: Sustained 7-Year glaucoma control after second-generation trabecular micro-bypass

Gerd Auffarth, MD, PhD, and the chairman at the Heidelberg University Eye Clinic discussed the 7 year, long-term data for the iStent inject second generation with our team at the 2023 ASCRS meeting in San Diego.

Video transcript

Editor’s note: Transcript lightly edited for clarity.

Gerd Auffarth, MD, PhD:

Hello, my name is Gerd Auffarth. I'm the chair at the Heidelberg University Eye Clinic talking here at the ASCRS in San Diego, actually on behalf of one of my faculty, Fritz Hengerer, about the iStent inject second generation, and we will share our 7 years' long-term, follow-up data here. It's very important, especially in this MIGS era, that we have long-term data because a glaucoma patient is a patient who is really suffering lifelong. We present this data on 125 patients that we followed up for 7 years. We have two groups, two cohorts, in this study. One was the standalone cohort, which is one-third of the patients and one is the cohort where we had a combined surgery, cataract surgery and implantation of the iStent inject.

Now, these groups were also a little bit different because in the standalone group, they had a higher intraocular pressure before surgery, and they had a higher amount of three to four medications. Actually, 75% of those patients had three to five meds. In the combined group, we had only 50% with this kind of medication, and also the pressure was slightly lower. Nevertheless, the effect was the same. Around 40% reduction was seen directly at the beginning, and the interesting thing is, in both groups, it kept that way for 7 years. When they started around 24 mm Hg, even after 7 years on average they were between 14 and 15 mm Hg, and the reduction on medication was around 60% on average, ranging between 50 to 70%.

So most of the patients were below one medication over the whole period. At the end, some of the patients moved up to one medication. In general, [it's a] very safe procedure...very good long-term stability of the data, and the patient didn't have any deterioration of severe glaucoma.