iStent inject® trabecular micro-bypass implantation as a stand-alone procedure or in combination with phacoemulsification cataract surgery: 6 month retrospective case review

Session Details

Session Title: Presented Poster Session: Glaucoma

Venue: Poster Village: Pod 2

First Author: : M.Economou SWEDEN

Co Author(s): :    T. Snaebjörnsson Arnljóts                       

Abstract Details

Purpose:

To investigate efficacy and safety of iStent inject as a standalone procedure vs. combined iStent inject and phacoemulsification in eyes with predominantly primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PXG).

Setting:

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

Methods:

Retrospective, consecutive case series of all patients with mainly POAG or PXG that underwent iStent inject alone or in combination with cataract surgery from October 2016 to October 2017 with a minimum follow-up of one month. Main study outcomes were IOP reduction, change in visual acuity (VA), number of antiglaucoma medications and complications related to the procedures. All surgeries were carried out by a single experienced surgeon.

Results:

Sixteen eyes in the iStent-alone group and 19 eyes in the combined group were included. Mean pre- and postoperative IOPs in the iStent-alone group 20.3 ± 5.1 and 15.9 ± 4.5 mmHg (mean reduction 4.4 ± 3.7 mmHg, p=0.0004); 21.7 ± 5.6 and 15.9 ± 3.1 mmHg in the phaco-iStent group (mean reduction 5.8 ± 4.8 mmHg). Number of antiglaucoma medications was significantly reduced in the combined group (3.0 ± 1.1 to 2.3 ± 1.0 (p=0.0010). No sustained vision-threatening complications were observed. Mean follow-up was 142.3 ± 82.7 in the iStent-alone and 155.4 ± 80.6 days in the combined group.

Conclusions:

In this short-term study implantation of iStent inject resulted in a promising and meaningful IOP reduction at the same time demonstrating a highly favorable safety profile. Furthermore, a combined procedure may provide an increasingly larger IOP reduction while simultaneously reducing the antiglaucomatous medication burden of the patients.

Financial Disclosure:

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