Cataracts Surgery with Glaucoma

A cataract is a natural clouding of the lens in the eye. Becuase the lens is responsible for focusing objects when the lens is cloudy seeing clearly becomes difficult. Usually, the cataract does not interfere with vision initially, and cataracts are not considered an urgent problem.

As we age, the chances of having a cataract increases. Because age is a risk factor for glaucoma as well, many patients with glaucoma also have cataracts.

Although all of us will eventually develop cataracts, the good news is that the treatment for cataracts is very successful with the latest surgical techniques. When treatment for a cataract is warranted, it is surgically removed and an artificial lens is put in its place.

Glaucoma, however, damages the optic nerve, the critical structure that transmits the visual signal from the eye to the brain. Unfortunately, in contrast to cataracts, we are not yet able to repair or replace the optic nerve. This important difference affects the management of these two diseases when they co-exist in the same eye.

Cataracts Surgery and Glaucoma with CyPass® Micro-Stent

CyPass Micro-Stent, a device for treatment of mild to moderate primary open-angle glaucoma that is intended to be implanted along with cataract surgery. The stent creates a channel for liquids to flow out from the anterior chamber of the eye, thereby reducing the intraocular pressure.

CyPass Micro-Stent

The clinical performance of the CyPass Micro-Stent system was evaluated by a study of 505 patients diagnosed with POAG. 374 patients were randomized to the CyPass Micro-stent in combination with cataract surgery, and 131 patients were randomized to cataract surgery alone. The study evaluated the percentage of patients with reduction of at least 20% in mean diurnal IOP from baseline and adverse events (AEs) for 24 months after implantation. Of the patients randomized to the stent, 72.5% achieved a significant lowering of their IOP, compared to 58.0% of patients who had cataract surgery alone.

There were no reports of patients implanted with the CyPass Micro-Stent experiencing loss of light perception, endophthalmitis, suprachoroidal hemmorrhage, diplopia, wound leak, flat anterior chamber, or bleb complications. The most serious AEs reported were rare instances of hypotony maculopathy, peripheral anterior choroidal effusion, intraocular lens (IOL) subluxation and corneal compromise. The most common safety concerns were related to bleeding, inflammation, and damage to angle tissue (i.e., iridodialysis, larger than expected cyclodialysis cleft, ciliary body edema). Due to the small size of the CyPass Micro-Stent, some patients experienced device malposition, device movement, and tube obstruction.