UMIN-CTR Clinical Trial

The mean IOP decreased from 14.8+/-2.3 mmHg at baseline to 10.0+/-3.1 mmHg at 12 months after surgery (P<0.0001). IOP reductions>20% were achieved by 61.5% of the eyes at 12 months. Adverse events were typical for filtration procedures, and none was deemed device-related. The mean corneal endothelial cell density had decreased by 3.3% at 12 months after surgery.

Eyes with NTG underwent EX-PRESS implantation with or without cataract surgery. 

A total of 37 eyes of 32 patients were enrolled and underwent filtration surgery; these eyes comprised the safety population. Both eyes of five patients underwent filtration surgery; both were included in
the safety analysis but only the eye with the higher baseline IOP (or the right eye if equal) was included in the efficacy analysis.

Postoperative ocular adverse events in the full data set of 37 eyes included choroidal　detachment in five eyes (13.5%), hyphema in four (10.8%), corneal epithelial defect in two (5.4%),　and epiretinal membrane, macular edema, blebitis, optic disc hemorrhage, and hypotony maculopathy in one eye each (2.7%).  

Mean IOP at baseline was 14.8 +/- 2.3 mmHg and was significantly reduced from baseline (p<0.0001) at all postoperative time points. Following the immediate postoperative period, IOP stabilized at 1 month, from Month 1 through Month 12, mean IOP ranged from 9.4-0.0 mmHg, mean IOP reductions from 4.9-5.4 mmHg, and percent IOP reductions from 21.1% to 35.4%. At Month 12, mean IOP was 10.0 +/- 3.1 mmHg, a reduction of 4.9 mmHg (31.1%) from baseline (p<0.0001). The proportions of subjects with a minimum 20% IOP reduction from baseline at 3, 6 and 12 months were 72.4%, 82.1%, and 61.5%, respectively. At baseline, all 34 eyes in the efficacy analysis set were on topical IOP-lowering therapy, with a mean of 3.3 +/- 1.0 medications per eye. Between Day 1 and Month 6 postoperatively, no eyes required IOP-lowering medication, and at Month 12, only one eye required topical medical therapy (mean 0.1 medication per eye). Survival analysis defined clinically relevant treatment failure as IOP >/= 12 mmHg or a <20% reduction from baseline at two consecutive study visits. According to this analysis, the cumulative survival rate 12 months after surgery was 55.9%. Mean BCVA over the study period remained unchanged, being 0.115 +/- 0.346 logMAR at baseline and 0.062 +/- 0.250 logMAR at Month 12 (p=0.6196). Mean astigmatism was also unaffected by the procedure, being -1.136 +/- 0.693 D at baseline and -1.635 +/- 0.923 D at Month 12(p=0.092). Mean corneal endothelial cell density decreased from 2658.9 +/- 287.7 cells/mm2 at baseline to 2546.8 +/- 246.1 cells/mm2 12 months after surgery. Although the difference, 95 cells/mm2, was statistically significant (p=0.0095), it represented only a 3.3% reduction in endothelial cell density, which was likely clinically insignificant.