Safety and efficacy of iStent Inject trabecular micro-bypass stents in combination with phacoemulsification for chronic open angle glaucoma associated with cataract

Background. - The goal of this study was to assess the efficacy and safety of phacoemulsification combined with iStent Inject((R)) implantation for the treatment of chronic open-angle glaucoma controlled on topical anti-glaucoma medications and associated with cataract. Methods. - This study was a retrospective analysis of patients who underwent phacoemulsification and implantation of an iStent Inject((R)) for chronic open-angle glaucoma associated with cataract. For all patients, pre- and postoperative characteristics, including number of glaucoma medications and intraocular pressure (IOP), were compared using Paired-sample t-tests and Wilcoxon signed-rank tests, respectively. Postoperative visits were scheduled at 7 days and 1, 3, 6, and 12 months after surgery. Results. - Forty-nine eyes of 39 patients were included in the study. Mean preoperative IOP at baseline was 16.3 +/- 4.3 mmHg (range, 10-29 mmHg) with a mean of 2.2 +/- 1.0 mmHg antiglaucoma medications. At 1 month, the mean IOP reduction was 16% (P < 0.05) along with an 18.7% reduction in the mean number of medications. At 6 months, the mean IOP was 12.8 +/- 2.6, witha mean of 1.1 +/- 0.9 antiglaucoma medications. The mean IOP reduction at 6 months was 22% (P < 0.05) along with a 49% reduction in the mean number of medications. At 12 months, themean IOP was 13.8 +/- 2.5 with a mean of 1.1 +/- 1.2 medications. The mean IOP reduction at 12 months was 15% (P < 0.05) along with a 47% reduction in the mean number of medications. No severe device-related side effects were observed. Conclusions. - iStent Inject((R)) implantation combined with phacoemulsification resulted ineffective IOP reduction and medication burden in patients with mild to advanced chronic open-angle glaucoma and preoperative IOP well controlled with topical hypotensive medications. (c) 2023 Elsevier Masson SAS. All rights reserved.