OUTCOMES OF COMBINED CATARACT SURGERY WITH TORIC INTRAOCULAR LENS IMPLANTATION AND TRABECULAR MICRO-BYPASS STENTS (ISTENT INJECT W) IMPLANTATION: A RETROSPECTIVE ANALYSIS
Published 2025 - 29th ESCRS Winter Meeting
Reference: PO101 | Type: Free Paper | DOI: 10.82333/yt68-xg80
Authors: Asaf Shemer* 1 , Michael Ostrovsky 1 , Biana Dubinsky-Pertzov 2 , Gil Peretz 1
1Department of Ophthalmology ,Shamir Medical Center,Tel Aviv,Israel, 2Division of Ophthalmology,McMaster UniversityFaculty of Health Sciences,Ontario,Canada;Department of Ophthalmology ,Shamir Medical Center,Tel Aviv,Israel
Purpose
To assess the refractive outcomes of combined cataract extraction with Toric intraocular lens (IOL) implantation and micro-bypass stents (iStent inject W) implantation
Setting
This is a retrospective study carried in the ophthalmology department in one academic tertiary medical center (Shamir Medical Center).
Methods
Glaucomatous eyes undergoing combined cataract surgery with Toric IOL and iStent between 2022 and 2024 were identified. Pre-operative, intraoperative and postoperative data was collected from the medical records for all eyes included in the study. Refraction, including spherical equivalent (SE) and astigmatic error, best-corrected visual acuity (BCVA) and uncorrected visual acuity (UCVA) was conducted in each visit. In addition, glaucoma control was assessed by intraocular pressure (IOP) measurements and the number of hypotensive drugs used over the follow-up time.
Results
In our study, 15 eyes of 10 patients with a mean age of 75.8 ± 1.88 and male predominance (60%) were included. Nine patients had primary open-angle glaucoma and one patient had pseudoexfoliation glaucoma, all with mild to moderate disease. Mean preoperative axial length, anterior chamber depth, and astigmatic error were 24.72 mm ± 0.40, 3.12 mm ± 0.08 and 3.37D ± 0.28, respectively. Overall, 46.7%of patients had 0.5D or less residual astigmatism and all eyes had a residual astigmatism of ≤1.0D. Spherical equivalent within ±0.25D, ±0.50D ,±1.00D of the target was observed in 40%, 93% and 100% of eyes. Regarding intraocular pressure, a significant reduction was seen in the mean IOP (15.07 vs 12.60 mmHg, p=0.008) at the final follow-up.
Conclusion
The combination of cataract surgery with Toric IOL and iStent Inject W achieved a satisfactory refractive outcome and effectively lowered intraocular pressure. Therefore, this combined approach can be considered as an effective treatment for patients with mild to moderate open-angle glaucoma who also have astigmatism and cataracts.