Long-term follow-up from the COMPASS trial reveals patients who had a combined cataract and Cypass supraciliary micro-stent implantation experience corneal endothelial cell loss (ECL) as far out as five years post-op. Researchers recently evaluated the two-year trial’s three-year safety extension data for 282 patients who had the combined procedure and 67 who had cataract surgery alone. Alcon removed the device from the market in 2018.

While patients in both groups had similar preoperative endothelial cell density, cell loss was more pronounced in the combination procedure group: -20.4% at 60 months compared with -10.1% in control group. The researchers note nine adverse events may have been related to ECL. Still, they found no significant differences in cell morphology between the groups.   

Although endothelial cell density continued to drop for at least five years, “clinical findings associated with ECL in these eyes were uncommon (3.3% of implanted eyes), suggesting that ECL is generally a subclinical phenomenon,” they concluded.

Lass JH, Benetz BA, He J, et al. Corneal endothelial cell loss and morphometric changes 5 years after phacoemulsification with or without Cypass micro-stent. Am J Ophthalmol. August 1, 2019. [Epub ahead of print].