April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Comparison of Outcomes of iStent with Cataract Surgery versus Cataract Surgery Alone in Open-Angle Glaucoma
Author Affiliations & Notes
  • Mia Miller
    Kresge Eye Institute, Detroit, MI
    Wayne State University School of Medicine, Detroit, MI
  • Bret Hughes
    Kresge Eye Institute, Detroit, MI
  • Joshua Apple
    Kresge Eye Institute, Detroit, MI
  • Chaesik Kim
    Kresge Eye Institute, Detroit, MI
  • Justin Tannir
    Kresge Eye Institute, Detroit, MI
  • Anju Goyal
    Kresge Eye Institute, Detroit, MI
  • Aman Shukairy
    Kresge Eye Institute, Detroit, MI
  • Chaesik Kim
    Kresge Eye Institute, Detroit, MI
  • Footnotes
    Commercial Relationships Mia Miller, None; Bret Hughes, Alcon (C), Alcon (R), Allergan (C), Allergan (R), Glaukos, Alcon, Allerg (C); Joshua Apple, None; Chaesik Kim, None; Justin Tannir, None; Anju Goyal, None; Aman Shukairy, None; Chaesik Kim, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 6126. doi:
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      Mia Miller, Bret Hughes, Joshua Apple, Chaesik Kim, Justin Tannir, Anju Goyal, Aman Shukairy, Chaesik Kim; Comparison of Outcomes of iStent with Cataract Surgery versus Cataract Surgery Alone in Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6126.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To evaluate the changes in intraocular pressure (IOP) and medication use with placement of the iStent in combination with cataract surgery versus cataract surgery alone in patients with primary open-angle glaucoma.

 
Methods
 

A retrospective chart review of 132 eyes diagnosed with cataract and primary open-angle glaucoma who underwent cataract surgery combined with Glaukos iStent implant versus cataract surgery alone. Intraocular pressures were measured through 6 months following surgery. Success was defined as post-surgery IOP <21mmHg on 1 or less medications with no additional surgeries. Statistical analysis was performed using unpaired t-test, chi square and Kaplan Meier survival analysis.

 
Results
 

The 132 eyes were comprised of two groups. Group 1 included 31 patients with moderate glaucoma who underwent cataract surgery with iStent placement. Group 2 included 101 patients with moderate glaucoma who underwent cataract surgery alone. The demographics of both groups were similar in age, gender, race, hypertension and diabetes prevalence and number of pre-op medications (p > 0.05). The mean pre-op IOP were 18.1 mmHg and 15.4 in Group 1 and Group 2, respectively (p = 0.0013). Using Kaplan Meier Survival Analysis we found a 76% success rate in Group 1 versus a 54% in Group 2 at six months (p = 0.42). Moreover, there was a significant reduction in the number of medications needed in both groups. Group 1 had a significantly greater reduction in post-operative medical dependency compared with Group 2, 0.37 and 1.4 medications, respectively at six months (p = 0.0039).

 
Conclusions
 

Our study shows that iStent implantation at the time of cataract extraction may be of benefit in patients with primary open-angle glaucoma. Although not statistically significant, there was greater success with IOP control in Group 1 compared to Group 2 by our criteria, as well as a statistically significant reduction in number of medications needed in Group 1 versus Group 2.

 
Keywords: 568 intraocular pressure • 735 trabecular meshwork • 743 treatment outcomes of cataract surgery  
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