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 i Stent implantation after phacoemulsification from May 2014 to February 2015 were included in our retrospective study. All iStents were implanted via 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(n=17), the mean number of hypotensive medications decreased from 2.2±1.2 at baseline to 0.8±1.3(P=0.05) and mean intraocular pressure decreased from 19.7±4.1 mm Hg at baseline to 16.7±2.1 mm Hg(P=0.58). Two eyes(5.9%) required subsequent trabeculectomy. CONCLUSION:The "landing strip" technique appears to be an effective way to assist with iS tent implantation.