Clinical Data

iStent inject® W Clinical Data

Trabecular micro-bypass technology developed by Glaukos has been studied extensively around the world and its efficacy has been demonstrated in more than over 200 peer-reviewed articles, 20 years of clinical use, and over 800,000 eyes.

The implantation of two trabecular bypass stents – without the benefit of cataract surgery – has been shown in prospective clinical trials to both lower IOP to <15 mm Hg and reduce medication burden via a unique two stent approach:

Can Reduce Intraocular Pressure (IOP) and
Medication Burden

iStent inject® W builds on the trabecular micro-bypass technology of iStent inject®, which has been proven effective in numerous studies in lowering IOP and reducing medication burden.

In one notable consecutive case study of iStent inject® involving multiple international surgeons, average medication usage was reduced from 1.0 to 0.1 at 12 months.1

At 12 month post-operative visit:

Chart showing average medication usage was reduced from 1.0 to 0.1 at 12 months.

Another study conducted by multiple international surgeons demonstrated a mean IOP reduction of 47% vs. medicated screening at 18 months, finding that stents alone lowered IOP 5.1 mmHg from medicated screening.2

At 18 month post-operative visit:

Line chart showing the mean IOP over time with a mean IOP reduction of 34% as compared to the medicated screening.

In a consecutive case series with three-year follow-up, mean IOP was 14.3 ± 1.7 mm Hg, representing a 37% reduction from preoperative medicated mean IOP of 22.6 ± 6.2 mm Hg, and 100% of eyes had an IOP ≤ 18 mm Hg.3

A bar graph showing sustained medication reduction: mean medication use was decreased from 2.5 to 0.8 medications at three years, a 68% reduction. Reduction key: dark green is 0 Med, green is 1 Med, dark blue is 2 Med, bright blue is 3 Med, blue is 4+ Med.

In the same consecutive case series, mean medication use was decreased from 2.5 to 0.8 medications at three years, a 68% reduction. And 74% of eyes were using 0 or 1 medication as compared to 21% preoperatively.3

References

  1. Donnenfeld ED, Solomon KD, Voskanyan L, et al. A prospective 3-year follow-up trial of implantation of two trabecular microbypass stents in open-angle glaucoma. Clin Opth. 2015;9:2057-2065.
  2. Samuelson TW. Outcomes of MIGS with Trabecular Micro-Bypass Stents and Prostaglandin in Open-Angle Glaucoma Subjects. Presented at the 2013 American Society of Cataract and Refractive Surgery Annual Meeting; April 19-23, 2013; San Francisco, California, USA.
  3. Hengerer FH. Personal Experience with Second-Generation Trabecular Micro-Bypass Stents in Combination with Cataract Surgery in Patients with Glaucoma: 3-Year Follow-up. ASCRS 2018 Presentation.

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iStent inject® W Important Safety Information

Indication For Use

The iStent inject® W (Model G2-W) is intended to reduce intraocular pressure safely and effectively in patients diagnosed with primary open-angle glaucoma, pseudo-exfoliative glaucoma or pigmentary glaucoma. The iStent inject® W can deliver two (2) stents on a single pass, through a single incision. The implant is designed to open a passage through the trabecular meshwork allowing for increased facility of outflow and a subsequent reduction in intraocular pressure. The device is safe and effective when implanted in combination with cataract surgery in those subjects who require intraocular pressure reduction and/or would benefit from glaucoma medication reduction. The device may also be implanted in patients who continue to have elevated intraocular pressure despite prior treatment with glaucoma medications and conventional glaucoma surgery.

Contraindications

In eyes with primary angle-closure glaucoma, or secondary angle-closure glaucoma, including neovascular glaucomas, in patients with retrobulbar tumor, thyroid eye disease, Sturge-Weber Syndrome or any other type of condition that may cause elevated episcleral venous pressure.

Warnings

This device has not been studied in patients with uveitic glaucoma. The surgeon should monitor the patient postoperatively for proper maintenance of intraocular pressure. iStent inject® W is MR-Conditional meaning that the device is safe for use in a specified MRI environment under specified conditions; please see labeling for details. Physician training is required prior to use. Do not re-use the stent(s) or inserter.

Adverse Events

Postoperative adverse events include but are not limited to: early postoperative corneal edema, posterior capsule opacification, stent obstruction, intraocular inflammation (non-preexisting), BCVA loss, and IOP increase requiring management with oral or intravenous medications or surgical intervention. Please refer to Directions for Use for additional adverse event information.

Caution

Please reference Directions for Use labeling for a complete list of contraindications, warnings and adverse events