Clinical effectiveness of combined cataract surgery with iStent inject implantation in the surgical treatment of open‐angle glaucoma

Abstract

Aims/Purpose: This study aims to evaluate intraocular pressure (IOP) change and reduction of topical IOP‐lowering medications after combined cataract surgery with iStentinject® implantation in the surgical treatment of open‐angle glaucoma.Methods: Retrospective chart review of 100 patients (100eyes) with different types of open‐angle glaucoma (84% ‐ primary open angle; 16% ‐ pseudoexfoliation glaucoma), who were naïve to any previous ocular procedure and underwent combined cataract surgery with iStent®implantation, was performed. Study outcomes were median IOP change in the operated eye and the mean number of topical IOP‐lowering medications at 3, 6 and 12 months after surgery.Results: The mean age of patients was 74 ± 7.5 years, 44% men and 56% women. The median pre‐ and postoperative IOP in the operated eye at 3, 6 and 12 months were 18.5(16–20) mmHg, 14.0 (12–16.75) mmHg, 14.5 (12–16) mmHg and 14.5 (12–16) mmHg, respectively. The median IOP change in the operated eyes at 3, 6 and 12 months follow up was −4 (−6 to −2) mmHg (p < 0.001), −4 (−6 to −1) mmHg (p < 0.001), and − 4 (−6.75 to −2) mmHg (p < 0.001), respectively. The higher the preoperative IOP level, the larger was the IOP‐lowering effect at different follow‐ups after surgery (−0.57, p < 0.001; −0.58, p < 0.001; −0.6, p < 0.001; at 3, 6 and 12 months, respectively). We found a statistically significant difference between the mean number of topical IOP‐lowering medications before and at 12 months after surgery (1.23 ± 0.8 vs. 1.08 ± 0.8; −3.42, p < 0.001).Conclusions: This study shows a statistically significant IOP reduction at 3, 6 and 12 months after combined cataract surgery with iStent® implantation in glaucoma patients. The higher the preoperative IOP in the operated eye, the larger the IOP‐lowering effect after surgery at all follow‐ups. iStent inject, a minimally invasive glaucoma surgery approach is associated with the reduction of topical IOP‐lowering medications at 12 months follow‐up.References (if any): Shalaby WS, Jia J, Katz LJ, Lee D. iStent inject: comprehensive review. J Cataract Refract Surg. 2021 Mar 1;47(3):385–399. doi: 10.1097/j.jcrs.0000000000000325.