Omni system, cataract surgery combination reduces IOP at 24 months – Vista Center for the Blind and Visually Impaired

Key Takeaways

A study looked at real-world outcomes with three minimally invasive glaucoma surgery (MIGS) devices in combination with cataract surgery compared to cataract surgery alone.
Patients treated with the Omni surgical system had the greatest reduction in intraocular pressure (IOP) and medication use.

Minimally invasive glaucoma surgery (MIGS) is a group of procedures used to treat glaucoma that use microscopic-sized equipment and tiny incisions. “Given the widespread implementation of MIGS procedures and the potential impact to health care costs, understanding associated practice patterns, glaucoma patient profiles and long-term clinical outcomes is crucial,” say the authors of a new study evaluating MIGS procedures published in the American Journal of Ophthalmology International. “A need therefore exists for studies evaluating the overall real-world evidence of effectiveness and safety of different MIGS techniques beyond 12 months.”

Michael Mbagwu, MD, and colleagues conducted a retrospective study using real-world data from the IRIS (Intelligent Research in Sight) Registry, a comprehensive eye disease clinical registry, to explore three MIGS devices — Omni surgical system (Sight Sciences), Hydrus (Alcon) and iStent inject (Glaukos) — in combination with cataract surgery. The study included 109,745 eyes of 77,391 patients; 428 patients were treated with Omni and cataract surgery, 1,435 patients were treated with Hydrus and cataract surgery, 4,769 patients were treated with iStent inject and cataract surgery, and 70,759 patients were treated with cataract surgery alone. Patients were stratified by their baseline IOP, and IOP and medication use were assessed at 24 months.

The researchers found that patients with glaucoma who underwent cataract surgery in combination with the Omni surgical system had lower IOP and used fewer medications at 24 months compared with outcomes with the other two devices or with cataract surgery alone. Nathan M. Radcliffe, MD, a Healio/OSN board member who was not involved in the study, said, “It does appear as if the Omni procedure delivered the most significant IOP reduction and medication reduction in this cohort.” He added, “Because it is not practically feasible to perform a five-armed randomized prospective study, this may be some of the best comparative evidence between the different MIGS procedures that we will see. And most importantly, this study shows that all types of MIGS procedures do provide more significant IOP and medication reduction than cataract surgery alone and should encourage surgeons not currently performing MIGS procedures to consider adopting these techniques for the benefit of their patients with cataract and glaucoma.”

Edited by Miriam Kaplan, PhD

Source: Alex Young, Healio Ocular Surgery News, April 12, 2024; see source article