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J GlaucomaFebruary 2016153 citations

Three-Year Follow-up of a Novel Aqueous Humor MicroShunt.

Batlle Juan F, Fantes Francisco, Riss Isabelle, Pinchuk Leonard, Alburquerque Rachel, Kato Yasushi P, Arrieta Esdras, Peralta Adalgisa Corona, Palmberg Paul, Parrish Richard K


AI Summary

This 3-year study found the InnFocus MicroShunt effectively lowered IOP to the low teens with minimal medications and transient side effects, offering a safe, sustained glaucoma treatment option.

Abstract

Aims

An observational study to determine the safety and efficacy of filtering surgery employing a microlumen aqueous drainage device (InnFocus MicroShunt), used intraoperatively with Mitomycin C, implanted alone or in combination with phacoemulsification.

Materials and methods

Single-site, prospective, nonrandomized study of 23 eyes that had failed maximum tolerated glaucoma medication, followed for 3 years. A MicroShunt was implanted ab externo through a needle tract under the limbus, draining aqueous from the anterior chamber to the scleral surface. Prespecified outcome measures include: intraocular pressure (IOP) control, with and without supplemental medication, success rate, medication use, and adverse events.

Results

Fourteen patients received the MicroShunt alone and 9 with cataract surgery. At 1 (n=23), 2 (n=22), and 3 (n=22) years of follow-up; the qualified success rate (IOP ≤ 14 mm Hg and IOP reduction ≥ 20%) was 100%, 91%, and 95%; mean medicated IOP was reduced from 23.8 ± 5.3 to 10.7 ± 2.8, 11.9 ± 3.7, and 10.7 ± 3.5 mm Hg, and the mean number of glaucoma medications/patient was reduced from 2.4 ± 0.9 to 0.3 ± 0.8, 0.4 ± 1.0, and 0.7 ± 1.1, respectively. The most common complications were transient hypotony (13%, 3/23) and transient choroidal effusion (8.7%, 2/23), all resolved spontaneously. There were no leaks, infections, migrations, erosions, persistent corneal edema, or serious long-term adverse events.

Conclusion

Surgery with the InnFocus MicroShunt transscleral aqueous drainage tube with Mitomycin C achieved IOP control in the low teens in most subjects up to 3 years of follow-up with only transient adverse events occurring within the first 3 months after surgery.


MeSH Terms

AdultAgedAged, 80 and overAlkylating AgentsAnterior ChamberAqueous HumorFemaleFollow-Up StudiesGlaucoma Drainage ImplantsGlaucoma, Open-AngleHumansIntraocular PressureLens Implantation, IntraocularMaleMiddle AgedMitomycinPhacoemulsificationProspective StudiesTonometry, OcularVisual Acuity

Key Concepts4

The InnFocus MicroShunt, used intraoperatively with Mitomycin C, achieved a qualified success rate (IOP ≤ 14 mm Hg and IOP reduction ≥ 20%) of 100% at 1 year, 91% at 2 years, and 95% at 3 years in a single-site, prospective, nonrandomized study of 23 eyes that had failed maximum tolerated glaucoma medication.

TreatmentCohortProspective Cohort Studyn=23 eyesCh41Ch45

The mean medicated intraocular pressure (IOP) in patients treated with the InnFocus MicroShunt, used intraoperatively with Mitomycin C, was reduced from 23.8 ± 5.3 mm Hg at baseline to 10.7 ± 2.8 mm Hg at 1 year, 11.9 ± 3.7 mm Hg at 2 years, and 10.7 ± 3.5 mm Hg at 3 years in a study of 23 eyes that had failed maximum tolerated glaucoma medication.

TreatmentCohortProspective Cohort Studyn=23 eyesCh41Ch45

The mean number of glaucoma medications per patient was reduced from 2.4 ± 0.9 at baseline to 0.3 ± 0.8 at 1 year, 0.4 ± 1.0 at 2 years, and 0.7 ± 1.1 at 3 years following surgery with the InnFocus MicroShunt, used intraoperatively with Mitomycin C, in a study of 23 eyes that had failed maximum tolerated glaucoma medication.

TreatmentCohortProspective Cohort Studyn=23 eyesCh28Ch41Ch45

The most common complications of surgery with the InnFocus MicroShunt were transient hypotony (13%, 3/23 eyes) and transient choroidal effusion (8.7%, 2/23 eyes), all of which resolved spontaneously within the first 3 months after surgery, with no leaks, infections, migrations, erosions, persistent corneal edema, or serious long-term adverse events observed in a 3-year follow-up study of 23 eyes.

TreatmentCohortProspective Cohort Studyn=23 eyesCh41Ch45

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