A real-world study has shown the effectiveness of the three most used minimally invasive glaucoma surgery (MIGS) systems at lowering intraocular pressure (IOP).
The study, published in the American Journal of Ophthalmology, used results from the American Academy of Ophthalmology IRIS Registry, said to be the largest specialty society clinical data registry in all of medicine.
It evaluated long-term two-year post-surgical outcomes among patients with primary open-angle glaucoma (POAG) treated with Glaukos’ iStent inject, Alcon’s Hydrus Microstent and Sight Sciences’ OMNI Surgical System combined with cataract surgery as well as standalone cataract surgery.
The OMNI system differs from traditional stent-based MIGS, instead adopting an implant-free, ab interno procedure that addresses areas of resistance in the conventional outflow pathway. It has been cleared by the FDA for canaloplasty followed by trabeculotomy to reduce IOP.
According to a press release from Sight Sciences, the study cohort consisted of 77,931 patients with glaucoma and 109,745 glaucomatous eyes. The overall population was divided into two subgroups depending on the baseline, pre-surgical lOP; > 18 mmHg and ≤ 18 mmHg.
Of those, 6,632 patients and 9,000 eyes received a MIGS procedure in combination with cataract surgery, and the remainder received cataract surgery alone.
The population was divided into two subgroups depending on the baseline, pre-surgical lOP; > 18 mmHg and ≤ 18 mmHg. The primary treatment goal for the high baseline IOP group (> 18mmHg) was IOP reduction, with a secondary goal to reduce medication burden. The primary treatment goal for the low baseline IOP group (< 18mmHg) was to reduce medication burden.
At 24 months, patients with high baseline IOP (>18mmHg) who received the outflow procedure using OMNI technology had the greatest reduction in IOP (30%) and medication use. IOP reduction was then followed by Hydrus at 25%, standalone cataract surgery at 24% and iStent inject at 22%.
Similarly, patients with low baseline IOP (≤ 18mmHg) who received the outflow procedure using OMNI technology had the greatest reduction in IOP as well as a statistically significantly greater mean medication use reduction compared to all other treatment groups.
“We are excited to see that large-scale comparison studies of MIGS standards-of-care continue to corroborate the robust IOP reduction and medication reduction associated with the comprehensive OMNI outflow procedure,” Mr Paul Badawi, co-founder and CEO of Sight Sciences, said.
More reading
‘Interventional glaucoma’ and what it means for these Australian ophthalmologists
How the iStent Inject can improve outcomes in patients with OSD and glaucoma
Alcon Hydrus – a MIGS microstent with macro results
Reference
Michael Mbagwu, Richard Chapman, Kristian Garcia, Cristina Masseria, Jaime E Dickerson, Louis B Cantor, Ab Interno Minimally Invasive Glaucoma Surgery Combined with Cataract Surgery and Cataract Surgery Alone: IRIS® Registry Study, AJO International, 2024,100015, ISSN 2950-2535.
