Mid-Term Evaluation of iStent Inject ® Trabecular Micro-Bypass Stent Implantation with or without Phacoemulsification: A Retrospective Study

• Published in: Clinical ophthalmology (Auckland, N.Z.) Vol. 14; pp. 4403 - 4413
• Main Authors: Silveira Seixas, Regina Cele, Balbino, Marcos, Basile Neto, Alberto, de Alcantara Almeida Costa, Amanda, Jordão, Marcelo Lopes da Silva, Russ, Heloisa Helena Abil
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2020; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Analysis; Cataract; Cataracts; Coronary artery bypass; Data integrity; Eye surgery; Glaucoma; glaucoma surgery combined with cataract surgery; Hypertension; Medical research; medical treatment; Medicine, Experimental; micro-invasive glaucoma surgery; Normal distribution; Ophthalmic drugs; Original Research; Research methodology; Software; Statistical analysis; Stent (Surgery); Surgeons; Surgery; Surgical outcomes; Survival analysis; trabecular micro-bypass; Variance analysis; Brazil; United States > US; glaucoma surgery combined with cataract surgery; medical treatment; micro-invasive glaucoma surgery; glaucoma; trabecular micro-bypass
• ISSN: 1177-5467; 1177-5483; 1177-5483
• DOI: 10.2147/OPTH.S283587

This study evaluated the 6-month performance and safety of micro-invasive glaucoma surgery (MIGS) with iStent inject either with or without cataract surgery.
Longitudinal retrospective study of 86 surgeries in 49 patients with inadequately controlled open-angle glaucoma (OAG) or ocular hypertension who underwent iStent inject trabecular micro-bypass implantation either alone (isolated group) or combined with cataract surgery (combined group). The two primary outcomes included an intraocular pressure (IOP) drop of ≥20% versus preoperative values (adequate drop) and IOP maintenance between 6 and 18 mmHg (adequate Range). For both outcomes, we determined "complete" and "qualified" success if patients did not require or did require glaucoma medications, respectively, at the end of follow-up. Safety outcomes included best-corrected visual acuity, adverse events, and secondary surgeries.
In the adequate drop analysis, 30.2% achieved "complete success," and 37.2% achieved "qualified success." For adequate range, 40.7% achieved "complete success" and 39.5% achieved "qualified success." There was no difference in medication decrease (p=0.77) nor IOP reduction (p=0.46) between the isolated and combined groups. Safety was generally favorable and similar between groups, with mild transient adverse events that resulted in no sequelae.
iStent inject implantation either with or without cataract surgery was able to safely decrease IOP and medication requirements through 6 months after surgery.