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  • Medication Burden After Combined CyPass/Cataract Surgery

    By Jean Shaw
    Selected By: Prem S. Subramanian, MD, PhD
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    Journal Highlights

    Journal of Glaucoma
    Published online May 26, 2020

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    Law et al. set out to assess how well combined cataract surgery and im­plantation of the CyPass Micro-Stent controlled intraocular pressure (IOP). They found that the combined surgery reduced the glaucoma medication burden at one year by 28% to 42%, de­pending on different target IOP levels.

    For this retrospective study, the authors reviewed all cases of combined surgery performed at two U.S. eye institutes between February 2017 and July 2018. The primary outcome was qualified success with IOP targets as follows: 1) final IOP of ≤18 mm Hg and reduction of 20%; 2) final IOP of ≤15 mm Hg and reduction of 25%; and 3) final IOP of ≤12 mm Hg and reduction of 30%. Secondary outcomes included post-op IOP and number of medications, complications, additional glaucoma surgery, and postoperative refractive error.

    All told, 141 eyes (107 patients) were included in the analysis. Mean pre-op IOP was 15.4 ± 3.4 mm Hg on an average of 2.2 ± 1.1 medications. At 12 months postoperatively, IOP was 13.8 ± 4.2 mm Hg, and medication use was 1.3 ± 1.3. Cumulative success rates based on the three IOP targets were 42%, 33%, and 28%.

    Fifteen eyes experienced a post-op IOP spike (defined as a postoperative IOP of ≥30 mm Hg or an increase of more than 10 mm Hg over preoperative IOP). Additionally, 13 eyes experienced 17 complications, and additional glau­coma surgery was performed in three eyes of two patients. Factors associated with failure included lower pre-op IOP, greater number of pre-op medications, and the occurrence of a post-op IOP spike. Further study is needed to de­termine the amount of long-term IOP control gained by combined surgeries.

    The original article can be found here.