Posters

Safety and efficacy of combined cataract surgery with iStent implantation in a population with varying severity of glaucoma

Poster Details

First Author: A.Bansal UK

Co Author(s):    L. Akshatha Ranganathan                    

Abstract Details

Purpose:

Primary Purpose: To evaluate the safety and efficacy of combined cataract surgery with iStent insertion in IOP reduction Secondary Purpose: To evaluate the local practice of combined cataract surgery with iStent insertion in Drops reduction Compare outcome between mild-to-moderate v.s. advanced and severely advanced glaucoma

Setting:

University Hospital Coventry & Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX

Methods:

This retrospective observational study included 43 eyes from 36 patients with OAG that underwent iStent implantationand cataract surgery between March 2013 and February 2016. Data included basic demographics, intraocular pressure (IOP), best corrected visual acuity (BCVA, logMAR), intra-operative data and surgical complications. Success was defined as IOP reduction of 20%, and/or reduction of glaucoma medication by one. Failure is defined as IOP increase of 15 mmHg above baseline, or further pressure-lowering surgeries performed.

Results:

The mean preoperative IOP was 20.34±3.56 mmHg. Patients were followed up for 3 to 36 month (median 24 month). 12 patients (27.9%) had advanced or severely advanced glaucoma. The mean number of glaucoma medications was 2.54±0.85 preoperatively and 2.11±1.14 (P<0.002196) at last follow-up.. At 2 year follow-up, IOP reduction is maintained at -4.46±1.34mmHg (P<0.0001). 36 patients (83.7%) achieved treatment success at final follow up. Six patients (14.0%) required additional surgical interventions qualifying as treatment failure. mean IOP reduction was -5.58mmHg for patients with mild-to-moderate glaucoma, and -4.8mmHg for patients with advanced glaucoma.

Conclusions:

The insertion of the iStent trabecular microbypass stent in combination with cataract surgery effectively lowers IOP in both early and advanced OAG over 2 year follow-up. Although medication use was not significantly reduced postoperatively, the safety profile appears favorable with a low rate of IOP spikes requiring additional surgery.

Financial Disclosure:

None