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Mohamad El Wardani, Farid Achache, Ciara Bergin, Kenza Bradly, Eamon Sharkawi; Istent implantation combined with phacoemulsification compared to phacoemulsification alone in primary angle closure and primary angle closure glaucoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2695. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To study the safety and efficacy of combined Istent implantation and phacoemulsification compared to phacoemulsification alone in primary angle closure or primary angle closure glaucoma.
A consecutive comparative study of 106 eyes with primary angle closure with ocular hypertension or glaucoma, underwent phacoemulsification alone (n=53 group I) or combined with surgical implantation of one or two Istents (n=53, group II). Preoperatively, all patients had a mean angle size of 0-20° on gonioscopy and required glaucoma medications. Pre and post-operative measures recorded included patient demographics, visual acuity, IOP, number of glaucoma medications and any complications. Patients were assessed preoperatively and on postoperative weeks 1, 3 and months 6 and 12
Postoperatively at 6 months, mean IOP decreased from 16.8 mmHg to 14.2 mmHg in group I, from 16.7 mmHg to 14.1 mmHg in group II. Mean glaucoma medication decreased from 1.9 to 1.8 in group I, from 2.3 to 1.2 in group II (p<0.05). There were no cases of Istent blockage. No major per- or postoperative complications were recorded in either groups.
Istent implantation combined with phacoemulsification was uncomplicated in eyes with narrow angles. Combined surgery resulted in similar IOP reduction to phacoemulfication alone, but achieved a significantly greater reduction in glaucoma medications. This may have positive implications for compliance, quality of life and health care costs in angle closure patients.
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