Clinical ophthalmology (Auckland, N.Z.) · 2026
Early Real-World Safety and Short-Term Outcomes of Combined iStent Infinite and Intracameral Travoprost Implant (iDose TR) with or without Cataract Surgery.
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Yadgarov Arkadiy
Аннотация
PURPOSE: To evaluate early real-world safety and short-term outcomes of combined trabecular bypass and intracameral travoprost implantation with or without cataract surgery in patients treated to optimize intraocular pressure control and/or reduce topical medication burden.
METHODS: This retrospective case series included eyes with open-angle glaucoma undergoing combined trabecular bypass and intracameral travoprost implantation with or without cataract surgery at a single center, with a minimum of three months of follow-up. The primary endpoint was a composite of ≥1 medication reduction without clinically meaningful intraocular pressure (IOP) worsening (increase <2 mmHg) or ≥20% IOP reduction with stable medication use at postoperative month three. Secondary endpoints included changes in IOP, medication burden, and safety. Baseline and postoperative outcomes were compared using generalized estimating equation models to account for inter-eye correlation, with exploratory subgroup analyses using independent t-tests and Fisher's exact tests.
RESULTS: Thirty-three eyes from 24 patients were included, including 18 standalone procedures and 15 combined with cataract surgery. At postoperative month three (POM3), the composite primary endpoint was achieved in 26 of 33 eyes (78.8%). Mean intraocular pressure decreased from 19.64±7.32 mmHg to 14.97±4.62 mmHg (mean reduction 4.67 mmHg; p<0.001), and mean topical medication burden decreased from 1.97±1.05 to 0.82±0.92 medications (p<0.001). No intraoperative complications, postoperative adverse events, layered hyphema, intraocular pressure spikes, device malposition, or return to the operating room occurred.
CONCLUSION: Combined trabecular bypass and sustained intracameral prostaglandin delivery demonstrated favorable early safety and clinically meaningful short-term control of both medication burden and IOP in a real-world cohort. Longer-term follow-up is warranted to assess durability.
METHODS: This retrospective case series included eyes with open-angle glaucoma undergoing combined trabecular bypass and intracameral travoprost implantation with or without cataract surgery at a single center, with a minimum of three months of follow-up. The primary endpoint was a composite of ≥1 medication reduction without clinically meaningful intraocular pressure (IOP) worsening (increase <2 mmHg) or ≥20% IOP reduction with stable medication use at postoperative month three. Secondary endpoints included changes in IOP, medication burden, and safety. Baseline and postoperative outcomes were compared using generalized estimating equation models to account for inter-eye correlation, with exploratory subgroup analyses using independent t-tests and Fisher's exact tests.
RESULTS: Thirty-three eyes from 24 patients were included, including 18 standalone procedures and 15 combined with cataract surgery. At postoperative month three (POM3), the composite primary endpoint was achieved in 26 of 33 eyes (78.8%). Mean intraocular pressure decreased from 19.64±7.32 mmHg to 14.97±4.62 mmHg (mean reduction 4.67 mmHg; p<0.001), and mean topical medication burden decreased from 1.97±1.05 to 0.82±0.92 medications (p<0.001). No intraoperative complications, postoperative adverse events, layered hyphema, intraocular pressure spikes, device malposition, or return to the operating room occurred.
CONCLUSION: Combined trabecular bypass and sustained intracameral prostaglandin delivery demonstrated favorable early safety and clinically meaningful short-term control of both medication burden and IOP in a real-world cohort. Longer-term follow-up is warranted to assess durability.