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Study compares success of stent, non-stent MIGS devices

Healio Optometry2d ago1 min read

KIAWAH ISLAND, S.C. — Non-stent MIGS devices provided better early IOP reduction and reduced medication use while stent MIGS devices had better long-term outcomes and helped prevent subsequent surgeries, according to a study.At Kiawah Eye and Retina, Hannah Istre-Wilz, MD, a resident at Storm Eye Institute, said she and colleagues wanted to explore the differences in short- and long-term outcomes of trabecular minimally invasive glaucoma surgeries with either stent or non-stent devices.“We did the stent-based cohort, so that was anyone who got anything from the iStent line (Glaukos) or the

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AI Summary

Quick Take

A comparative study of trabecular MIGS procedures found that non-stent devices provide superior early IOP reduction and medication relief, whereas stent-based implants offer better long-term stability. Specifically, stent-based devices like the iStent line were more effective at preventing the need for subsequent glaucoma surgeries over time.

Why It Matters

The MIGS category is no longer a monolith, and this research helps refine the selection process between stenting and non-stenting techniques. It suggests a clinical trade-off: non-stent procedures may be preferable for immediate pressure control, while stents provide a more durable benefit for long-term management. This distinction is crucial for surgeons balancing the immediate needs of a high-pressure patient against the long-term goal of surgical avoidance.

Key Findings

Non-stent MIGS devices outperformed stents in the early postoperative phase regarding both IOP reduction and the reduction of medication burden.
Stent-based MIGS devices, including the iStent line, demonstrated higher success rates in long-term outcomes.
The use of stent-based devices was associated with a reduced risk of requiring subsequent, more invasive glaucoma surgeries.
The study specifically focused on trabecular-based minimally invasive glaucoma surgeries to compare short- and long-term efficacy.

Practice Implications

Clinicians should weigh the patient's immediate clinical needs against their long-term prognosis when selecting a MIGS device. Non-stent options may be better suited for patients needing rapid medication reduction, while stents should be considered for those where preventing future surgical intervention is the primary objective.

Who's Affected

Glaucoma SpecialistsCataract SurgeonsComprehensive OphthalmologistsOptometrists

Evidence StrengthPreliminary

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