Posters

Multi-iStent inject® implantation (four stents) in open-angle glaucoma: a glimpse into the future

Poster Details

First Author: M.Economou SWEDEN

Co Author(s):    T. Arnljots                    

Abstract Details

Purpose:

To report the initial clinical results of doubling the standard amount of iStent inject implantations on intraocular pressure (IOP).

Setting:

St. Erik Eye Hospital at the Karolinska Institute in Stockholm is a tertiary referral center for glaucoma surgery serving the whole of Sweden.

Methods:

Retrospective, non-randomised, interventional case series review of all surgeries between April 2018 and January 2019 where a total of four (4) second generation iStent devices were implanted at the same occasion, either as a single procedure or combined with standard phacoemulsification cataract surgery. Main outcome measures were IOP, visual acuity, number of glaucoma medications and complications. All surgeries were performed by the same experienced surgeon (MAE).

Results:

A total of 13 eyes (13 patients) were included (7 primary open-angle glaucoma, 5 pseudoexfoliative glaucoma, 1 normal-tension glaucoma). Seven cases were performed as single procedures and 6 combined with cataract surgery. Mean pre- and postoperative IOPs and number of glaucoma medications (±SD) were 23.2 ± 6.2 and 15.5 ± 3.9 (p = 0.0004) as well as 3.2 ± 1.1 and 3.0 ± 1.0 (p = 0.5016), respectively. An IOP drop of > 40% was observed in five eyes. Visual acuity remained unchanged. No significant complications were observed. Mean follow-up was 4.7 ± 3.0 months.

Conclusions:

This short-term pilot study shows a promising and statistically significant IOP-lowering effect of simultaneous implantation of four iStent inject devices without any clinically significant side effects. Whether the implantation of an additional two stents in fact confers an incremental IOP drop compared to standard two-stent implantation as well as which patients may benefit most from this approach is subject to further investigation.

Financial Disclosure:

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