Implantation of trabecular micro-bypass stent using a novel "landing strip" technique.

AIM

To describe a novel technique of creating a landing strip within the trabecular meshwork to guide trabecular micro-bypass stent (iStent) implantation in patients who underwent phacoemulsification.

METHODS

Thirty-four eyes from 30 patients who underwent iStent implantation after phacoemulsification from May 2014 to February 2015 were included in our retrospective study. All iStents were implanted the "landing strip" technique. A 25-gauge microvitreoretinal blade was used to bisect the trabecular meshwork to less than 1 clock-hour, effectively creating a landing strip. The iStent applicator was pressed along the landing strip and then the stent was released into the trabecular meshwork.

RESULTS

Of the 34 eyes with iStent implantation, 27 (79.4%) eyes had primary open-angle glaucoma, 6 (17.6%) eyes had pseudoexfoliation glaucoma, and 1 (2.9%) eye had ocular hypertension. At 6-month follow-up (=17), the mean number of hypotensive medications decreased from 2.2±1.2 at baseline to 0.8±1.3 (=0.05) and mean intraocular pressure decreased from 19.7±4.1 mm Hg at baseline to 16.7±2.1 mm Hg (=0.58). Two eyes (5.9%) required subsequent trabeculectomy.

CONCLUSION

The "landing strip" technique appears to be an effective way to assist with iStent implantation.