Iop Lowering Effect And Reduction Of Antiglaucomatous Medication After Trabecular Istent Inject® W (3Rd Generation) –24 Month Results

To evaluate the IOP-lowering effect and antiglaucomatous medication reduction of trabecular iStent inject^® W (3^rd generation) implantation for open angle glaucoma (OAG) treatment.

Single center, single surgeon study, Germany

21 eyes of 16 OAG patients aged 61±11 years had iStent inject^® W (3^rd generation) implantation. 16 eyes had primary OAG, three pseudoexfolation glaucoma, one pigmentary glaucoma and one secondary glaucoma. Six eyes were phakic and 15 eyes were pseudophakic. 19 eyes underwent iStent inject^® W implantation as a standalone procedure, in two eyes combined cataract surgery was performed. The IOP and hypotensive medication usage was assessed preoperatively and postoperatively to 24 months. The rate of medication free eyes was assessed.

Mean intraocular pressure (IOP; mmHg) and mean number of antiglaucomatous medications (in brackets) was 19.2±4.3 (1.8) preoperatively. Postoperative mean IOP and number of medications was 17.7±2.6 (0.5) at 12 months (n=21), 15.5±1.4 (0.6) at 18 months (n=11), and 15.8±1.1 (0) at 24 months (n=6). At 12 months 12 of 21 eyes (57%), at 18 months 7 of 11 eyes (64%), and at 24 months 6 of 6 eyes (100%) were without antiglaucomatous medication. 3 eyes had transient IOP spikes within the first postoperative days, no other complications occurred.

iStent inject^® W (3^rd generation) implantation lowers IOP and significantly decreases the need for antiglaucomatous medication in OAG eyes. Larger case series are needed to compare these results to former iStent inject^® (2^nd generation) success rates. Consistent with current literature, a high safety profile was observed.