Short Term Surgical Outcomes of iStent Inject W Implantation in Open Angle Glaucoma Eyes with High Myopia.

Abstract

Purpose : To compare the surgical efficacy and safety of iStent inject W implantation in eyes with High Myopia (HM) and non HM.

Methods : This single center retrospective comparative case series included subjects with open angle glaucoma who underwent iStent inject W implantation combined with phacoemulsification. Subjects were categorized as non HM (axial length [AL] < 26.0mm), HM (AL ≥ 26.0 mm). Through a 12-month postoperative follow-up, the effectiveness was quantified by changes in intraocular pressure (IOP) and antiglaucoma medication number, and surgical success defined as IOP reduction ≥ 20% with postoperative IOP ≤18 mm Hg and reduction of ≥1 medication. Safety measures included adverse events, and secondary surgery.

Results : This evaluation included 115 eyes (57 non HM, 58 HM). At baseline, the mean IOP was 16.0 ± 3.8 mmHg in non HM group, 14.1 ± 2.6 mmHg in the HM group. The mean IOP at 12 months significantly decreased both in non HM (12.5 ± 2.9 mmHg) and HM (12.4 ± 2.2 mmHg) groups (P < 0.001). The mean number of antiglaucoma medications at the baseline was 2.6 ± 1.5 in non HM group, and 2.9± 1.4 in HM group. At 12 months, the mean number of antiglaucoma medications significantly decreased in both non HM and HM groups compared to the baseline (1.5 ± 1.5 and 1.8 ± 1.1, P < 0.001 and P = 0.002, respectively). The percent reduction in IOP from baseline was similar in both non HM and HM group (19.1 ± 15.3 % and 12.8 ± 15.6 % reduction, respectively). There was no statistically significant difference in the reduction in IOP between non HM and HM groups (P = 0.268). Success rates were 45% (non HM), 35% (HM) at 12 months. A similarly high safety profile was observed in both groups.

Conclusions : iStent inject W implantation with cataract surgery in eyes with HM resulted in substantial and safe reductions in IOP and medications similarly to eyes with non HM.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.