Study Shows Superior Success Rate for ExTra ELT Compared With Trabectome in Patients With Glaucoma Plus Cataract Surgery
ELT Sight announced that in the largest published study to date on excimer laser trabeculostomy (ELT), the ExTra ELT procedure plus cataract surgery was superior to ab interno trabeculectomy with the Trabectome plus cataract surgery, according to a company news release. The 245-patient study, titled “Success of combined cataract extraction plus excimer laser trabeculotomy exceeds that of combined ab interno trabeculectomy with the trabectome or cataract extraction alone,” was published online in the journal International Ophthalmology.
Patients in the retrospective, non-randomized, comparative single surgery center study (Hamburg, Germany) underwent one of three procedures: combined ELT plus cataract surgery, trabeculectomy with the Trabectome device plus cataract surgery, or cataract surgery alone.
At 1-year postoperative, ELT plus cataract surgery significantly reduced IOP and medication use, which are two major and challenging treatment goals for cataract patients with glaucoma. Additionally, ExTra ELT plus cataract surgery was significantly superior in Kaplan-Meier survival analysis at 1 year compared to the other two techniques. The significantly longer mean survival time for the ExTra ELT group persisted beyond the study period in the post-hoc analysis in the comparison with the Trabectome plus cataract surgery and the cataract surgery alone groups.
Authors Lidija Jozic, Joachim Magner, Jens Funk and Marc Töteberg-Harms stated in the discussion of their findings that “thermal approaches can induce scarring and thus limit long-term success as shown by the Kaplan-Meier statistics when comparing phaco-ELT and phaco-aiT [ab interno trabeculectomy].”
Regarding safety, no serious complications occurred in any of the three groups perioperatively and during the follow-up period. Additionally, none of the treated eyes required a subsequent surgery to lower the IOP within the 12-month follow-up period.
“In this largest published study to date on excimer laser trabeculostomy, ExTra ELT safely lowered IOP below the mid-teens and reduced medication use by nearly two-thirds,” Matilda Parente, MD, Chief Medical Officer of ELT Sight, said in the news release.
“This is welcome news for surgeons seeking a non-thermal, implant-free alternative for their cataract patients with mild-to-moderate glaucoma,” Dr. Parente added.
ELT is not yet available in the United States, and clinical studies in the United States are expected to begin in 2020 following a regulatory-approved pathway for ExTra ELT.