Initial clinical results after implantation of second-generation trabecular micro-bypass stents (iStent inject®) with cataract surgery

Session Details

Session Title: Microinvasive Glaucoma Surgery

Session Date/Time: Sunday 15/09/2019 | 14:00-16:00

Paper Time: 15:30

Venue: Free Paper Forum: Podium 4

First Author: : K.Gundersen NORWAY

Co Author(s): :                                 

Abstract Details

Purpose:

Prospective single-surgeon case series to evaluate outcomes following implantation of two second-generation trabecular micro-bypass stents (iStent inject®) with concomitant cataract surgery in patients with primary open-angle glaucoma (POAG) or pseudoexfoliative glaucoma (PXG). Three-month results are presented, and follow-up is ongoing.

Setting:

Private cataract surgery practice in Haugesund, Norway.

Methods:

We evaluated the baseline clinical characteristics and 3-month outcomes of patients with POAG or PXG who underwent implantation of two iStent inject stents with concomitant cataract surgery by a single surgeon at a single site. Effectiveness measures included mean intraocular pressure (IOP) and medication burden. Safety measures included best-corrected visual acuity and adverse events and complications. Tracking of iStent inject cases is ongoing with an aim to report on a larger dataset with longer follow-up by the time of the presentation.

Results:

Thirty-one eyes of 20 patients were included, with an average age of 74.6±10.0 years and diagnoses of either POAG (n=23) or PXG (n=8). Comparing outcomes at 3 months postoperative (n=14) versus preoperative (n=31), mean IOP reduced by 32% to 15.4 mmHg versus 22.5 mmHg, with 86% of eyes achieving IOP ≤ 18 mmHg. Meanwhile, mean medication count reduced by 62% to 0.6 medication versus 1.5 preoperatively. Favorable safety was comparable to cataract surgery alone, including no stent-related adverse events and stable visual acuity, with 20/20 acuity in 79% of eyes and 20/40 in 100% of eyes at 3 months.

Conclusions:

The present prospective study provides preliminary real-world data on the utility of iStent inject in combination with cataract surgery in a clinically heterogeneous patient population with POAG or PXG in a private cataract practice in Scandinavia. Patients experienced meaningful reductions in both IOP and medication burden through 3 months postoperative, with favorable safety and visual outcomes comparable to cataract surgery alone.

Financial Disclosure:

None