Kevin H Chen1, Won I Kim2. 1. Uniformed Services University of the Health Sciences. 2. Glaucoma Service, Ophthalmology, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences.
Abstract
PURPOSE: To report the first successful implantation of a CyPass supraciliary stent combined with 2 targeted iStent trabecular microbypass stents in a phakic primary open-angle glaucoma patient with markedly elevated intraocular pressures (IOP) on maximum tolerable medical therapy. METHODS: Case report. RESULTS: A 52-year-old phakic male patient with primary open-angle glaucoma with uncontrolled IOP in the right eye (OD) of 36 mm Hg on maximal topical pharmacotherapy. The patient underwent implantation of a single CyPass supraciliary stent combined with the targeted implantation of 2 iStent trabecular microbypass stents, 1 right facing stent and 1 left facing stent. Postoperatively, off of all glaucoma medications, the IOP decreased to 10 mm Hg on day 1 and continued to be controlled between 10 to 13 mm Hg until postoperative month 6, with only 1 glaucoma medication added after postoperative month 5. In addition, there were no postoperative complications to date. CONCLUSIONS: The combined implantation of a CyPass supraciliary stent and iStent trabecular microbypass stents can successfully lower IOP and decrease medication burden with minimal risk for complications.
PURPOSE: To report the first successful implantation of a CyPass supraciliary stent combined with 2 targeted iStent trabecular microbypass stents in a phakic primary open-angle glaucomapatient with markedly elevated intraocular pressures (IOP) on maximum tolerable medical therapy. METHODS: Case report. RESULTS: A 52-year-old phakic male patient with primary open-angle glaucoma with uncontrolled IOP in the right eye (OD) of 36 mm Hg on maximal topical pharmacotherapy. The patient underwent implantation of a single CyPass supraciliary stent combined with the targeted implantation of 2 iStent trabecular microbypass stents, 1 right facing stent and 1 left facing stent. Postoperatively, off of all glaucoma medications, the IOP decreased to 10 mm Hg on day 1 and continued to be controlled between 10 to 13 mm Hg until postoperative month 6, with only 1 glaucoma medication added after postoperative month 5. In addition, there were no postoperative complications to date. CONCLUSIONS: The combined implantation of a CyPass supraciliary stent and iStent trabecular microbypass stents can successfully lower IOP and decrease medication burden with minimal risk for complications.