Safety and Efficacy of iStent Inject® Trabecular Micro-Bypass Stents in Combination with Phacoemulsification for Chronic Open Angle Glaucoma Associated with Cataract

Abstract Background The goal of this study was to assess the efficacy and safety of phacoemulsification combined with iStent Inject® 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® 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 repeated measures ANOVA. 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, with a 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, the mean 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® implantation combined with phacoemulsification resulted in effective IOP reduction and medication burden in patients with mild to advanced chronic open-angle glaucoma and preoperative IOP well controlled with topical hypotensive medications.