Posters

Cataract surgery with iStent inject® implantation in high-risk glaucoma and ocular hypertension: six-month results

Poster Details

First Author: Y.Leng UK

Co Author(s):    M. Lane   S. Dulku                 

Abstract Details

Purpose:

To report the 6-month intraocular pressure (IOP) data and outcomes for patients undergoing phacoemsulsification with iStent inject implantation for high-risk glaucoma and ocular hypertension.

Setting:

University Hospitals Birmingham NHS Foundation Trust, United Kingdom

Methods:

Retrospective observational consecutive case series.  Inclusion criteria were patients needing cataract surgery for visual improvement or to treat primary angle closure with at least one of the following: 2 or medications to control IOP, mean deviation (MD) on Humphrey visual field of <-4dB, severe glaucoma in the other eye, or inability to instil eye drops (e.g. dementia, psychiatric illness). 30 eyes of 29 patients were included.

Results:

Baseline characteristics: Mean IOP 19.5mmHg (SD 4.7, range 12-31), Mean medications 2.1 (range 0-4), median MD -7.8dB (range -0.76, -31.14).  The mean IOP on the same day postoperatively (1-24h) was 16.5mmHg; at 1 week 13.6mmHg; 1 month 16.3mmHg; 3 months 15.0mmHg; 5-9 months 14.8mmHg (SD 3.6, range 6-22).  Mean medications at 5-9 months was 1.6 (range 0-3).  One patient required trabeculectomy at 3 months with IOP 18mmHg on 3 medications; their 3-month values were carried forward.  Mean reduction in IOP was 4.7mmHg (95% CI 2.9 – 6.6mmHg, p<0.0001).  Mean reduction in medications was 0.47 (95% CI 0.05 – 0.88, p=0.028).

Conclusions:

The iStent inject was safe when used in a cohort of patients with high-risk glaucoma and ocular hypertension on a mean of 2.1 medications pre-operatively.  At 5-9 months there was a clinically and statistically significant reduction in IOP of 4.7mmHg.  This was achieved with a small decrease in the number of medications.  In this high-risk cohort, one patient required trabeculectomy to stabilise their field despite a pressure of 18mmHg.  The iStent Inject allows cataract surgery to be safely performed with good postoperative pressure control when there is established glaucoma, high pressure or risk factors for non-compliance.

Financial Disclosure:

None