Real-world assessment of second-generation trabecular micro-bypass stents in open-angle glaucoma patients

Abstract

Background: To assess the safety and efficacy of iStent inject placement in individuals with glaucoma with open angles in real world clinical settings. Methods: A review was conducted on the medical records of individuals who received iStent inject implants starting from March 2018. The analysis focused on reductions in intraocular pressure (IOP) and glaucoma medication usage. Safety assessments encompassed intraoperative and postoperative issues, additional surgeries, and improvements in best-corrected visual acuity (BCVA). Results: Analysis of 55 eyes of 48 patients that underwent iStent implantation revealed a mean age of 77 years (range: 51–97). The initial average intraocular pressure (IOP) in these eyes was 20.2 ​± ​6.4 ​mm Hg. Following surgery, IOP decreased by ​≥ ​20% compared to preoperative levels in 21 eyes (43.8%) over the 12-month follow-up period. Notably, there was a significant reduction in medication usage by the 12-month mark (P ​< ​0.0042). Among the evaluated eyes, 9 exhibited a response to steroids, 3 had stents that were improperly positioned, 5 had stents that were over implanted, and 1 eye experienced an episode of iris prolapse. Conclusions: The findings from the 12-month follow-up of iStent inject implants in standard clinical settings demonstrate a notable decrease in both intraocular pressure (IOP) and medication usage in eyes with concurrent open-angle glaucoma.

Keywords

• Glaucoma
• iStent inject
• Intraocular pressure