2 Year results of combined phacoemulsification‐ iStent inject W, from a single centre

Abstract

Aims/Purpose: Our aim is to review the 2 year results of combined phacoemulsification and iStent inject W implantation in a single centre in East London.Methods: Patients were listed for surgery when cataract surgery was needed and further control of glaucoma was necessary. Electronic medical records were reviewed of all the patients who underwent the procedure in the period ranging from May 2018 until February ‘21. 87 eyes of 77 patients were identified, 3 eyes were lost to follow up in year one and 2 year data were obtained for 17 eyes. Vision, iop, drop dependency was measured and complications were recorded. Further surgical treatment was considered failure and the patient was then removed from the cohort.Results: Mean vision improved from LogMAR 0,45 to 0,16 stable throughout the two years. Drop dependency dropped modestly from 2,71 to 2,49 (8%) in year one and 2,35% (13,04%) in year two. IOP dropped from 19,25mHg to 14,55 mmHg (24,43%) in year one and 12,41 mmHg (36,68%) in year two. Complications included one patient with retained lens matter, 1 with recurrent uveitis, 1 iris prolapse, 1 Irvine Gass syndrome,1 had steroid response and 2 had pressure spikes. Furthermore by year 2, 1 patient was excluded due to incomplete documentation, 2 were discharged, 4 died (6 eyes), 4 patients needed further treatment with trabeculectomy and one received micropulse cyclodiode laser.Conclusions: Overall combined phacoemulsification/iStent inject W surgery is safe, effective, does not affect the overall safety profile of phacoemulsification surgery and has a place in early and moderate glaucoma. Improvement in year 2 results in comparison to year one can be explained by the removal from the study of the patients that received further treatment; and the small number of patients seen is an effect of the reduced capacity because of the COVID‐19 pandemic restrictions during that time.