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
Shields Classification
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.
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.
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.
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.
Related Articles5
Safety profile of minimally invasive glaucoma surgery.
ReviewClinical outcomes of Preserflo MicroShunt implant procedure in open‑angle glaucoma patients - a 1000 eyes case-series; including subanalysis of combined cataract-glaucoma surgery and standalone surgery in pseudophakic eyes.
Case SeriesGlaucoma control after phacoemulsification in eyes with functioning glaucoma filtration surgeries: trabeculectomies versus glaucoma drainage devices.
Cohort StudyMinimally Invasive Glaucoma Surgery: Is It Here to Stay?
ReviewResponse: Comment on "Phacogoniotomy versus phacotrabeculectomy for advanced primary angle-closure glaucoma with cataract: A randomized non-inferiority trial".
Randomized Controlled TrialIs this article assigned to the wrong chapter(s)? Let us know.