Implantation of two trabecular micro-bypass devices (iStent 

, Glaukos) reduced intraocular pressure (IOP) at least as effectively as a fixed combination of latanoprost/timolol in patients who had open-angle glaucoma that was not controlled by one medication, according to a study reported in 

Researchers at eight sites in six countries randomized 192 patients into two groups: 94 patients received implantation of two of the trabecular micro-bypass devices in the treated eye, and 98 received medical therapy with latanoprost/timolol (Xalacom, Pfizer).

The researchers found 89 of the eyes in the stent group (94.7%) had an unmedicated IOP reduction of ≥20% 1-year post-surgery compared to baseline unmedicated IOP. In the medical therapy group after 12 months, 88 eyes (91.8%) had an IOP reduction ≥20% versus baseline unmedicated IOP.

More eyes in the stent group had a ≥50% level of IOP reduction: there was a statistically significant 17.5% between-group treatment difference at that level of IOP reduction (

 = 0.02). IOP of ≤18 mmHg was found after 1 year in 87 eyes (92.6%) in the stent group and 88 eyes (89.8%) in the medical therapy group. The mean IOP decrease from screening was 8.1 ±2.6 mmHg in the stent group and 7.3 ± 2.2 mmHg in the stent group.

Based on measurements of best-corrected visual acuity, cup-to-disc ratio, and adverse events, both groups had a high safety profile.

 is at least as effective as two medications, with the clinical benefit of reducing medication burden and assuring continuous treatment with full compliance to implant therapy," the researchers wrote.

Articles

Glaucoma

Implantation of two trabecular micro-bypass devices (iStent inject, Glaukos) reduced intraocular pressure (IOP) at least as effectively as a fixed combination of latanoprost/timolol in patients who had open-angle glaucoma that was not controlled by one medication, according to a recent study.