Other non-implant MIGS show efficacy if stent with vascular bypass fails to control IOP

November 23, 2022

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Terveen reports receiving a research grant from Sight Sciences.

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Other non-implant MIGS interventions ie. surgery and angioplasty, allows patients to achieve good IOP control if previous microcapsulation has failed to maintain IOP as desired.

In a multicenter retrospective study conducted at five US centers, the results of 27 patients treated with a trabecular micro-bypass stent (iStent or iStent inject, Glaukos) and subsequently with the Omni surgical system (Sight Sciences) were treated for inadequate pressure control.


Terveen reports receiving a research grant from Sight Sciences.
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Mean IOP decreased from 22.3 mm Hg at baseline to 17.1 mm Hg at 3 months and 17.2 mm Hg at last follow-up; 85% of patients had an IOP of less than 21 mm Hg at last follow-up, and 56% had an IOP of 18 mm Hg or less.

The number of medications decreased from an average of 2.2 at baseline to 1.2 at 3 months and 1.8 at the last follow-up; 81.5% of patients were on the same number of medications or fewer at the last follow-up, and 30% had completely stopped taking medications. The Omni procedure was well tolerated and side effects were mostly mild, temporary and self-resolving.

MIGS is an increasingly widespread intervention for mild-to-moderate glaucoma when patients have inadequate control of IOP-lowering drops or have problems with tolerance or adherence, the authors said. Trabecular micro-bypass stents are commonly used as a first-line procedure and can successfully treat many patients. However, when a first MIGS fails, escalation of treatment does not rule out a second MIGS, as this study shows. According to the authors, this second intervention may be preferable to adding other drugs, which can lead to reduced efficacy, increased side effects, and compliance issues.

“We believe that an additional study of [Omni surgical system] in this population is warranted and we look forward to confirming our findings in additional studies by other investigators,” the authors said.

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