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Kevin Lodewyk, Nariman Nassiri, Chaesik Kim, Anju Goyal, Justin Tannir, Aman Shukairy, Mark S Juzych, Bret A Hughes; Outcomes of Phacoemulsification Vs Combined Phacoemulsification and iStent Implant in Glaucomatous Eyes. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4925.
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© ARVO (1962-2015); The Authors (2016-present)
The iStent has gained popularity in the treatment of mild to moderate glaucoma. In this retrospective longitudinal study, we aimed to investigate 18-month outcomes of phacoemulsification with or without combined iStent implantation in glaucoma patients.
We included glaucoma patients who underwent phacoemulsification with or without combined iStent implantation at Kresge Eye Institute from April 2007 to July 2016. Two groups were compared at baseline and different intervals with regard to best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of IOP-lowering medications (Table 1). Chi square and t test were used to compare the study outcomes between two groups. P value < 0.05 considered statistically significant.
The two groups were comparable with regard to age, gender, race, diabetes, hypertension, BCVA, number of IOP-lowering medications and severity of glaucoma based on mean deviation (MD) at baseline (p > 0.05; Table 1). The combined group had statistically higher baseline IOP compared to the phacoemulsification group (17.5 ± 5.1 vs.15.8 ± 4.2, respectively; p=0.006; Table 1). While BCVA and IOP were comparable between groups, eyes in the combined group required significantly less IOP-lowering medications during all follow-up visits (p<0.001; Table 2). Compared to baseline, IOP and number of medications significantly reduced from 15.8 ± 4.2 and 1.41 ± 0.95 at baseline to 15.72 ± 3.37 (p=0.006) and 0.28 ± 0.69 (p<0.001) at 12 months and 15.44 ± 4.21 (p=0.01) and 0.51 ± 0.82 (p<0.001) at 18 months in the combined group (Table 2). Compared to baseline, IOP statistically reduced to 14.29 ± 3.63 (p=0.02) at 12 months and 14.05 ± 3.23 (p=0.02) at 18 months in the phacoemulsification group; however, the number of medications did not show any significant difference at 12 and 18 months (p>0.05 for both; Table 2).
While two groups were comparable with regard to BCVA and IOP, eyes in the combined group required less IOP-lowering medications during 18 months of follow up. Compared to baseline, IOP significantly reduced 12 and 18 months after surgery in both groups while number of medication only reduced in the combined group.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Baseline characteristics in phacoemulsification vs phacoemulsification and iStent groups.
Comparison of study outcomes in phacoemulsification and phacoemulsification with iStent study groups over 18 month follow-up.
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