Two-Year COMPASS Trial Results: Supraciliary Microstenting with Phacoemulsification in Patients with Open-Angle Glaucoma and Cataracts

Vold, Steven D.; Ahmed, Iqbal Ike K.; Craven, E. Randy; Mattox, Cynthia; Stamper, Robert L.; Packer, Mark; Brown, Reay H.; Ianchulev, Tsontcho

doi:10.1016/j.ophtha.2016.06.032

Cited by 214 publications

(177 citation statements)

References 20 publications

(14 reference statements)

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“…These data have demonstrated that implanting single1, 2, 3, 4 or multiple5, 6, 7, 8 first‐generation iStent devices, either with or without cataract surgery, can provide long‐term IOP and medication reduction in patients with mild to moderate glaucoma. In addition, MIGS procedures with these stents have demonstrated a positive benefit‐to‐risk profile in comparison to that of filtering surgeries9 or suprachoroidal stent placement 10, 11…”

Section: Introductionmentioning

confidence: 99%

Implantation of two second‐generation trabecular micro‐bypass stents and topical travoprost in open‐angle glaucoma not controlled on two preoperative medications: 18‐month follow‐up

Berdahl

Voskanyan

Myers

et al. 2017

Clinical Exper Ophthalmology

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ImportanceAdditional data are sought regarding treatment options for glaucoma, a major cause of global blindness.BackgroundThe study assessed outcomes following standalone implantation of two second‐generation trabecular micro‐bypass stents and postoperative topical prostaglandin in eyes with open‐angle glaucoma not controlled on two preoperative medications.DesignThe study design is a prospective, nonrandomized, open‐label study at a tertiary‐care ophthalmology centre.ParticipantsSubjects had open‐angle glaucoma with preoperative intraocular pressure of 18–30 mmHg on two medications, a medication washout phase, and post‐washout intraocular pressure of 22–38 mmHg. All subjects (N = 53) have been followed for 18 months.MethodsOne day following implantation of two second‐generation trabecular micro‐bypass stents, subjects started topical travoprost. Medication washout was repeated at month 12.Main Outcome MeasuresThe main outcome measure was the proportion of eyes with intraocular pressure reduction ≥ 20% versus medicated baseline intraocular pressure with reduction of one medication at 12 months.ResultsAt 12 months, 91% of eyes achieved intraocular pressure reduction ≥ 20% with reduction of one medication. All eyes had intraocular pressure ≤ 18 mmHg with reduction of one medication, and 87% had intraocular pressure ≤ 15 mmHg. Mean intraocular pressure on one medication was ≤ 13.0 mmHg (≥ 34% reduction) through 18 months. Mean post‐washout intraocular pressure at month 13 was 33% lower than preoperative unmedicated intraocular pressure. No adverse events occurred through 18 months.Conclusions and RelevanceIn open‐angle glaucoma eyes on two preoperative medications, treatment with two second‐generation trabecular stents and one postoperative prostaglandin resulted in mean intraocular pressure ≤ 13 mmHg with reduction of one medication, with favourable safety. These findings show the utility of second‐generation trabecular bypass with postoperative prostaglandin in patients with open‐angle glaucoma.

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Section: Introductionmentioning

confidence: 99%

Implantation of two second‐generation trabecular micro‐bypass stents and topical travoprost in open‐angle glaucoma not controlled on two preoperative medications: 18‐month follow‐up

Berdahl

Voskanyan

Myers

et al. 2017

Clinical Exper Ophthalmology

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“…Mean IOP reduction following phacoemulsification/CyPass was 30% from baseline mean of 24.4 mmHg and number of glaucoma medication was also significantly reduced. No serious adverse events were described in either group at 24 months [7,8].…”

Section: Suprachoroidalmentioning

confidence: 83%

Minimally Invasive Modalities for Treatment of Glaucoma: An Update

Lee¹,

Amoozgar²,

Han³

2017

J Clin Exp Ophthalmol

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Purpose of Review: In recent years, Minimally Invasive Glaucoma Surgery (MIGS) and laser-based procedures have been gaining popularity as glaucoma treatment options. As such, they represent active areas of research. This article reviews some of the notable recent and forthcoming developments in this field. Recent Findings:The MIGS devices and cyclophotocoagulation have been focused on achieving satisfactory success rate as either combined with phacoemulsification or standalone procedure. They also have superior safety profile when compared to traditional incisional glaucoma surgeries. In addition to the promising data available thus far, more comprehensive investigations on the long-term efficacy and safety of these interventions are currently underway.Summary: New minimally invasive surgical modalities have shown considerable potential in intraocular pressure (IOP) and the number of post-surgical medications with rare complications. The rising popularity of these devices and procedures may represent a shift in treatment paradigm from medical therapy towards earlier surgical intervention, especially in the treatment of mild-to-moderate glaucoma.

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“…23 This was supported by the 2-year results from the pivotal COMPASS trial on patients (n=505) with unmedicated IOPs in the range 21-33 mmHg and receiving pharmacoemulsification cataract surgery. 24 Study findings showed an early and sustained reduction in IOP in 77% of microstent subjects achieving ≥20% unmedicated IOP lowering versus baseline at 24 months compared with 60% of controls (p=0.001).…”

Section: Q: What Advances Have There Been In Minimally Invasive Glaucmentioning

confidence: 89%

Recent Developments in Glaucoma

Lim¹

2017

European Ophthalmic Review

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Glaucoma continues to exert a heavy disability and economic burden and is the most frequent cause of irreversible blindness worldwide. In 2015, 57.5 million people globally were affected by open-angle glaucoma and this is predicted to increase to 65.5 million by 2020. The prevalence of glaucoma increases with age in all populations and generally more men and people of Hispanic and Black race are affected. Effective treatments to lower and maintain intraocular pressure (IOP) and convenient means of continuously monitoring it remain substantial unmet medical needs. In this expert interview Kin Sheng Lim from Guy’s and St Thomas’ Hospitals, London, UK, discusses the new developments to improve this situation and are therefore of great interest to ophthalmologists and to the wider population who are at risk from glaucoma.

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Two-Year COMPASS Trial Results: Supraciliary Microstenting with Phacoemulsification in Patients with Open-Angle Glaucoma and Cataracts

Cited by 214 publications

References 20 publications

Implantation of two second‐generation trabecular micro‐bypass stents and topical travoprost in open‐angle glaucoma not controlled on two preoperative medications: 18‐month follow‐up

Implantation of two second‐generation trabecular micro‐bypass stents and topical travoprost in open‐angle glaucoma not controlled on two preoperative medications: 18‐month follow‐up

Minimally Invasive Modalities for Treatment of Glaucoma: An Update

Recent Developments in Glaucoma

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