Abstract
Purpose :
To report the 1-year surgical outcomes of phaco-iStent and phaco-iStent inject W implantation in Japanese patients with primary open-angle glaucoma (POAG) and the risk factors for failure.
Methods :
Consecutive cases with mild to moderate POAG, including normal tension glaucoma, who underwent phaco-iStent (Sep/2018-Mar/2019) or phaco-iStent inject W (Oct/2020-Dec/2021) with ≧1-year follow-up were retrospectively analyzed. Clinical information such as intraocular pressure (IOP) and glaucoma medication number were collected from electronic medical charts, and the outcomes were compared between the iStent types. Surgical failure ware defined as any secondary glaucoma surgery, IOP >18 mmHg, or use of hypotensive medications at two consecutive visits 1 week after surgery.
Results :
51 eyes of 39 patients (18 phaco-iStent, and 33 phaco-iStent inject W) were included.
Preoperative IOP and glaucoma medication were 14.1 ± 2.8 mmHg and 1.9 ± 1.1 in phaco-iStent group; and 15.0 ± 3.4 mmHg and 2.8 ± 1.1 in phaco-iStent inject W group. Both groups showed significant reduction of IOP and medication at 12 month after surgery (12.8 ± 3.1 mmHg and 1.1 ± 1.0 medications in phaco-iStent group; and 14.0 ± 2.8 mmHg mmHg and 1.3 ± 1.2 medications in phaco-iStent inject W group). Between groups, the percentage reduction of IOP was higher with phaco-iStent, while the number reduction of medication was larger with phaco-iStent inject W. The 12-month cumulative event-free survival rate was 22.2% in phaco-iStent group and 36.4% in phaco-iStent inject W group. There was no significant difference in survival rate between the two groups. (P = 0.14) Risk factor analysis demonstrated that preoperative high IOP was related to surgical failure.
Conclusions :
Phaco-iStent and phaco-iStent inject W were both effective in reducing IOP and glaucoma medication in Japanese patients with relatively low-tension glaucoma. Patients with high preoperative IOP should be carefully followed-up after iStent surgery.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.