Ab Interno Minimally Invasive Glaucoma Surgery Effectiveness in Black Patients: An IRIS Registry Study.

PRÉCIS: MIGS in combination with cataract surgery resulted in clinically significant reductions in IOP and IOP-lowering medications up to 24 months in Black patients.

PURPOSE: Describe outcomes following ab interno Minimally Invasive Glaucoma Surgery (MIGS) procedures US FDA cleared or approved for intraocular pressure (IOP) reduction in primary open angle glaucoma combined with cataract surgery and cataract surgery alone in Black patients.

METHODS

An observational, retrospective study of glaucoma in Black patients treated with MIGS (Hydrus®, iStent Inject®, OMNI® Surgical System) with cataract surgery or cataract surgery alone, in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight). Deidentified data included glaucoma diagnosis, procedure data, IOP, and medication use from preoperatively through 24 months. The study period was 07/01/2016 and 12/31/2023. Eligible patients identified via Current Procedural Terminology codes coupled with electronic health records. Outcomes were changes in IOP, and medication class usage (months 6, 12, 18, and 24) stratified by baseline IOP (≤18; >18 mm Hg).

RESULTS

In 12,828 eyes of 12,828 patients, including 189 Hydrus, 491 iStent, 91 OMNI, and 12,057 cataract surgeries, mean IOP and medication use decreased significantly in each cohort. Mean IOP reductions were in the range of 1.2-2.7 mm Hg, and medication reductions were 0.4-1.0 medications across all cohorts and time points. In MIGS cohorts, IOP reductions were greater with higher baseline IOP, and medication reductions were greater with lower baseline IOP.

CONCLUSIONS

Each MIGS procedure produced clinically and statistically significant reductions in both IOP and IOP-lowering medications up to 2 years postoperatively in Black patients. Surgeons could consider offering MIGS at the time of cataract surgery to this population.