Posters

Real-world experience with iStent inject® second generation trabecular micro-bypass combined with phacoemulsification: a Canadian study reporting one-year outcomes

Poster Details

First Author: P.Harasymowycz CANADA

Co Author(s):                        

Abstract Details

Purpose:

To assess one-year postoperative outcomes following implantation of iStent inject (2nd generation trabecular micro-bypass stents) implanted with concomitant cataract surgery in patients with mild to severe glaucoma.

Setting:

Academic ophthalmology center in Montreal, Canada.

Methods:

In this retrospective case series, the baseline clinical characteristics and the 12-month outcomes of patients with mild to severe glaucoma who underwent implantation of two iStent inject devices with concomitant cataract surgery were evaluated at a single ophthalmology clinic. The primary outcomes included the intraocular pressure (IOP) and anti-glaucoma medication use. The secondary outcomes were complete success rate (IOP≤18 mmHg without any anti-glaucoma medications) and qualified success rate (IOP≤18 mmHg with or without anti-glaucoma medications). Changes in IOP and medications were evaluated using repeated measure ANOVA with significance set at p<0.05.

Results:

101 eyes of 61 patients were included with an average age of 68.5±8.8 years. All eyes had mild to severe glaucoma with the following subtypes: 56% primary open-angle, 18% primary closed-angle, 13% normal-tension, 7% pseudoexfoliation, 5% pigmentary, and 1% congenital glaucoma. IOP was significantly reduced to 14.3±2.8 from preoperative 16.6±4.0 mmHg (p<0.001), and the average anti-glaucoma medication use dropped by 53% at one-year follow-up (p<0.001). Qualified and complete success rates were 90.1% and 38.6%, respectively. There were no intraoperative complications; however, eight eyes underwent secondary surgery for management of elevated IOP unrelated to the stent.

Conclusions:

The present study provides clinically relevant, real-world data on the utility of iStent inject with cataract surgery in a heterogeneous, adequately sized patient population.  Patients experienced meaningful individual-level reductions in medication burden, while participants’ already-low IOP was reduced further. IOP and medication reductions were sustained consistently through 12 months postoperative, and safety was favorable. Outcomes were similarly beneficial in mild to severe glaucoma patients.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented