The STARflo™ glaucoma implant: a single-centre experience at 24 months
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To evaluate the 24-month outcomes following STARflo™ implantation in patients with moderate or advanced open-angle glaucoma.
We enrolled 32 patients (40 eyes) with high intraocular pressure (IOP) resistant to topical and systemic medical therapy. After baseline assessments, patients were implanted with STARflo™ implants with the goal of IOP reduction and long-term maintenance. Patients were followed for 24 months. Complete success of implantation was defined as a restoration of normal IOP without topical glaucoma medications, while qualified success was defined as a restoration of normal IOP with implantation and topical glaucoma medications.
STARflo™ did not satisfactorily reduce IOP at 24 months. Twenty-eight eyes (70%) had elevated IOP at least once during the 24 months post-implantation period. Five eyes (12.5%) developed corneal decompensation. The average IOP 24 months after the surgery was 13.42 ± 6.03 mmHg and was not significantly different than IOP at 12 months (13.2 ± 5.59 mmHg). Moreover, 45% of treated eyes needed additional glaucoma procedures after 1 year and 2 years to achieve these IOPs. STARflo™ did reduce the average number of topical glaucoma medications from 2.7 pre-implantation to 1.17 at 24 months postoperatively in the rest 55% of the eyes.
The STARflo™ implantation did not meet success criteria and so appears to be an ineffective alternative to filtering surgical procedures for patients with treatment-refractory open-angle glaucoma.
KeywordsSTARflo™ implant Intraocular pressure Glaucoma Loss of corneal endothelial cells Corneal decompensation
argon laser trabeculoplasty
blebless ab-externo glaucoma surgery
Descemet membrane endothelial keratoplasty
corneal endothelial cell density
micro-invasive glaucoma surgery
posterior chamber intraocular lenses
primary open-angle glaucoma
pattern standard deviation
selective laser trabeculoplasty
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee of St. Johannes Hospital in Dortmund, Germany, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was freely given and obtained from all participants in this study.
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