Trabecular Microbypass Istent Inject W Implantation Combined With Cataract Surgery In Open-Angle Glaucoma Eyes – 6-Month Outcomes

To evaluate the effectiveness of the trabecular microbypass iStent Inject® W (Glaukos) implantation in combination with phacoemulsification in reducing medications in open-angle glaucoma eyes over a 6-month period.

Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain.

Non-randomised, single-centre, retrospective case series of glaucoma eyes undergoing iStent Inject W implantation combined with phacoemulsification. Adult patients with no prior glaucoma surgery and intolerant or non-compliant with medications were eligible for inclusion. Primary outcome effectiveness measures include reduction number of glaucoma medications and stabilisation of intraocular pressure (IOP).

Fifty-eight eyes of 46 patients (mean age 71.1±14.8 years) were included. Mean baseline IOP was 18.0±3.2 mmHg and was reduced to 16.2±2.5 at 6 months (p=0.001). Mean number of medications was 2.0±0.9 at baseline and was significantly reduced to 0.7±0.9 (p<0.001; -65%). No eye was medication-free at baseline versus 59% (n=34) at 6 months. In glaucoma eyes with an IOP≤18mmHg at baseline, mean IOP was stable (15.8±1.9 at baseline; 15.8±2.5 at 6 months) while medications were reduced from 1.8±0.8 at baseline to 0.4±0.8. In glaucoma eyes with an IOP>18mmHg at baseline, both IOP and medications were reduced from 20.9±2.1 and 2.3±1.1 at baseline to 16.8±2.3 and 1.0±1.1 at 6 months respectively. No eyes have experienced adverse events.

iStent Inject W implantation combined with phacoemulsification resulted in a significant reduction in mean IOP and glaucoma medications. In uncontrolled IOP eyes, the stent implantation has brought IOP under control and reduced the number of medications, while in controlled IOP eyes, it has reduced the number of medications.