EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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3 of the CyPass Micro-Stent for the surgical treatment of open-angle glaucoma when implanted in con- junction with cataract surgery. The study included 167 eyes of 142 patients with open-angle glaucoma who underwent combined phacoemulsification with intraocular lens insertion and Micro-Stent implanta- tion into the supraciliary space. Patients were divided into two groups: those with a baseline IOP of 21 mmHg or higher (65 patients) and those with a medicated baseline IOP of less than 21 mmHg (102 patients). Glaucoma medications were discontinued or tapered at surgery. Patients' mean follow-up was 294±121 days, and no major intra- operative or postoperative complications occurred. Patients' mean preoperative baseline IOP was 20.2±6.0 mmHg, and their mean number of IOP-lowering medications was 2.0±1.1. Patients with a medicated baseline IOP of 21 mmHg or higher demonstrated a 35% decrease in mean IOP and a 49% reduction in mean glaucoma medication usage. Those with a medicated baseline IOP of less than 21 mmHg had a 75% reduction in mean medication usage while maintaining a mean IOP of less than 21 mmHg. Mean IOP at 12 months was 15.9±3.1 mmHg in all eyes, which was a reduction from baseline of 14%. 2 In summary, the CyPass Micro-Stent, in conjunction with phacoemulsification, effectively demonstrated sustained unmedicated IOP lowering along with an excellent safety profile as CyPass Micro-Stent in the supraciliary space Fig. 1: Percentage of eyes achieving ≥20% reduction in unmedicated IOP at 24 months Fig. 2: Percentage of responders † that were medication-free at 24 months † Those patients who attained an unmedicated mean diurnal IOP reduction of 20% or more as compared with baseline in the absence of IOP-affecting surgery during the study 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% 24M **p=0.0011 72.5% of Eyes Achieved >20% Reduction in IOP at 2 years 28% more micro-stented eyes met IOP reduction goal 85% of micro-stented eyes required no medication at 2 years vs. 59% of controls Compass Trial Results: % of Patients on No Medications Percent of Eyes 72.5% ** 58.0% 60.0% 80.0% 100.0% Patients 93.0% 72.4% +14.5% +20.6% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% 24M **p=0.0011 72.5% of Eyes Achieved >20% Reduction 28% more micro-stented eyes met IOP reduction goal 85% of micro-stented eyes required no medication at 2 Compass Trial Results: % of Patients on Percent of Eyes 72.5% ** 58.0% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% 24M Percent of Patients 93.0% 72.4% +14.5% +20.6% IOP-lowering vs. cataract surgery by a TWO POINT DIFFERENCE Patients on No Medications Mean Diurnal IOP Reduction from Baseline CyPass ® Micro-Stent + Cataract surgery Cataract surgery Percent DiŽerence CyPass ® Micro-Stent + Cataract surgery (n=374) Cataract surgery (n=131) -5.3 32% Reduction in IOP at 2 years reduction goal Microstenting improved IOP-lowering vs. cataract surgery by a TWO POINT DIFFERENCE Compass Trial Results: % of Patients on No Medications Absolute Unmedicated Mean Diurnal IOP Reduction from Baseline IOP Range 6–18 mmHg CyPass ® Micro-Stent + Cataract surgery Cataract surgery Percent DiŽerence CyPass ® Micro-Stent + Cataract surgery (n=374) Cataract surgery (n=131) -7.0 ** -5.3 -12 -10 -8 -6 -4 -2 0 24M mmHg **p<0.0001 32% +32% demonstrated in the COM- PASS trial. This is truly a special time for ophthalmol- ogists to treat glaucoma in patients undergoing cataract surgery. Surgeons now have another MIGS option for their patients to control IOP at the time of cataract sur- gery with the high potential of reducing the glaucoma medication burden. n References 1. Vold S, Ahmed II, Craven ER, et al; CyPass Study Group. Two-year COMPASS trial results: Supraciliary microstenting with phacoemulsification in patients with open-angle glaucoma and cataracts. Ophthalmology. 2016;123(10):2103-2112. 2. Hoeh H, Vold SD, Ahmed IK, et al. Initial clinical experience with the CyPass Mi- cro-Stent: Safety and surgical outcomes of a novel supraciliary microstent. J Glaucoma. 2016;25(1):106-112. Please see page 4 for Important Product Information.