Posters

12 month results for iStent inject in a real-world national health service setting

Poster Details

First Author: H.Kaneshayogan UK

Co Author(s):    S. Merugumala   A. Booth   S. Waqar              

Abstract Details

Purpose:

To evaluate 1-year results of patients with all types of glaucoma and ocular hypertension who underwent iStent Inject surgery, and to guide clinicians in making an informed decision on its effectiveness, within a typical NHS glaucoma service.

Setting:

University Hospitals Plymouth NHS Trust Derriford Hospital, Derriford Road, Plymouth

Methods:

Data was collected retrospectively from a single tertiary ophthalmology hospital for 43 patients with a diagnosis of glaucoma or ocular hypertension, who had an iStent Inject procedure, with or without cataract surgery over a 1-year period. The primary outcome was reduction in intraocular pressure and number of glaucoma medications at 12 months post operatively. Other aims included reporting complications from surgery, achieving target pressure or 20% reduction in IOP and requirement for further pressure lowering surgery

Results:

Mean IOP reduced from 20.7 mmHg preoperatively to 15.4 mmHg (26% reduction, P<0.0001) at 12 months. 65% achieved a drop of at least 20% from their pre-operative IOP. Overall there was no difference in the average number of topical antihypertensive agents pre stent insertion (2.14) and post stent insertion (2.14). In the group requiring iStent to avoid trabeculectomy 12/43 (28%), the mean pre-operative IOP was 21.08mmHg and post-operative IOP prior to any filtration surgery was 15.72mmHg, a 25% reduction. 1 (2%) patients went on to have a trabeculectomy within 1 year of having an iStent insertion due to inadequate pressure control.

Conclusions:

iStent Inject is an effective treatment modality in moderate to severe glaucoma of varying aetiology and ocular hypertension, with a good safety profile. Patients on maximal topical therapy and previous laser trabeculoplasty can be counselled to expect a 20-25% reduction in post-operative IOP reduction at 1-year, however it is difficult to recommend to patients that they will have a significant drop reduction based on these results.

Financial Disclosure:

None