Abstract
Purpose :
This retrospective study assessed the 12-month safety and effectiveness of iStent® or iStent inject® trabecular micro-bypass implant with cataract surgery in patients with ocular hypertension (OHT) or glaucoma.
Methods :
Parameters analysed were age at date of surgery, gender, ethnic origin, previous treatments, condition treated, implant type, visual acuity, intraocular pressure (IOP) and number of glaucoma agents at time points pre-op, 1 week, 4-6 weeks, 3, 6 and 12 months post op, Humphrey Mean Deviation (MD) at time points pre-op and 12 months post-op.
Results :
70 patients and 82 eyes were operated for phacoemulsification with iStent® or iStent inject® from Apr 2017 to Aug 2018. 58 patients underwent 1 eye surgery and 12 in both. Sample was predominantly female (55 eyes), Caucasian (24 eyes) with mean age 75.27±6.46years. 71 eyes had no previous glaucoma operation, 6 iridotomies, 3 selective laser trabeculoplasty, and 2 trabeculectomies. Condition treated was mainly POAG (43 eyes) or OHT (17 eyes). 43 eyes were implanted with the iStent®, 36 with iStent inject® and in 3 type of stent wasn't recorded. 73 eyes didn't have any intraoperative complication and 5 had significant hyphema obscuring the view (resulting in abandoning insertion in 1 case). In 1 eye an iris cleft was caused. In 2 eyes the insertion was abandoned without hyphema. In 1 case the second implant did not release.
MD (24-2 SITA Fast) of eyes treated with cataract iStent/iStent inject® improved during the studied period (-6.67±5.72dB pre-op to -5.83±6.00dB 12 months post-op, p=0.047).
IOP was found reduced in all time points; mean IOP pre-op was 17.49mmHg reduced to 15.27 at 1 week (p=.000), 15.41 at 4-6 weeks (p=.002), 13.88 at 3 months (p=.000), 14.62 at 6 months (p=0.000) and 14.78 at 12 months (p=.000).
Glaucoma agents were reduced at all time points; mean number of medication used was 1.89 pre-operatively, 1.48 at time point 1 week post-operatively (p=.002), 1.18 at week 4-6 (p=.001), 1.24 at 3 months (p=.083), 1.60 at 6 months (p=.080) and 1.51 at 12 months (p=.016). 2 patients needed trabeculectomy.
Conclusions :
In our cohort study combined phacoemulsification with iStent® or iStent inject® implantation achieved reduction of IOP and glaucoma medications with improvement of visual function quality with safe profile.
This is a 2020 ARVO Annual Meeting abstract.