Glaukos iStent inject® Trabecular Micro-Bypass Implantation Associated with Cataract Surgery in Patients with Coexisting Cataract and Open-Angle Glaucoma or Ocular Hypertension: A Long-Term Study

Abstract

Purpose. To evaluate the long-term efficacy and safety of the iStentinjectdevice (Glaukos Corporation, Laguna Hills, CA) combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma or ocular hypertension (OHT).Methods. A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma or OHT and cataract. Patients underwent cataract surgery along with the implant of two iStentinjectdevices. Outcome measures were intraocular pressure (IOP), topical hypotensive medications required, and best-corrected visual acuity (BCVA).Results. 20 patients were enrolled. Mean follow-up was47.4±18.46months. Mean baseline IOP was19.95±3.71 mmHg with medication and26±3.11 mmHg after washout. Mean end-follow-up IOP was16.25±1.99 mmHg, representing an IOP decrease of 36.92%,9.74±3.14 mmHg (P<0.001), from baseline washout IOP. The mean number of medications was significantly reduced from1.3±0.66to0.75±0.79(P=0.017). 45% of patients were medication-free by the end of follow-up. Meanlog⁡MARBCVA improved significantly from0.42±0.16to0.18±0.16(P<0.001). No complications of surgery were observed.Conclusion. The iStentinjectdevice combined with cataract surgery served to significantly reduce both IOP and medication use in the long term in patients with coexistent open-angle glaucoma or ocular hypertension (OHT) and cataract.