Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Intraocular pressure reduction after combined phacoemulsification and iStent implantation

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Session Details

Session Title: Presented Poster Session: Combined Cataract Surgery

Session Date/Time: Saturday 10/09/2016 | 15:00-16:30

Paper Time: 15:00

Venue: Poster Village: Pod 1

First Author: : A.Nagar UK

Co Author(s): :    M. Nagar              

Abstract Details


Abnormalities within the trabecular meshwork are the leading cause of elevated intraocular pressure (IOP) in patients with open angle glaucoma. Recently, a titanium L-shaped trabecular micro-bypass stent has been introduced. It bypasses the major source of resistance to aqueous outflow. The primary efficacy outcome measure was IOP after combined phacoemulsification & iStent insertion in patients with cataract and coexistent mild to moderate glaucoma. The secondary outcome measure was the number of drops pre and postoperatively. Safety outcome measures were intra & postoperative complications and best corrected visual acuity.


Patients with cataract and coexisting mild to moderate open angle glaucoma, controlled or uncontrolled on medical treatment underwent phacoemulsification & intraocular lens implantation along with ab-interno, gonioscopically guided implantation of one Glaukos iStent. The new surgical technique was explained and an Information leaflet on Phacoemulsication and iStent implantation was given.


This is a prospective analysis of 28 patients (34 eyes) who underwent phacoemulsification with iStent insertion from August 2013 – August 2015. Patient follow up ranged from 3-24 months. A single iStent was inserted following uneventful cataract surgery with intraocular lens implantation, all procedures were performed by a single surgeon (MN). Electronic medical records were used to collect patient demographics and outcome data. This included visual acuity, change in IOP, change in glaucoma medications and complications. Postoperative visits were scheduled for Day 1, Week 1, Month 1, 3, 6, & Year 1& 2


Mean IOP reduction of at least 2 mmHg at 1 month follow up was 6.1mmHg (2 -18). 3 patients had worsening of IOP at this stage and 2 were lost to follow up. At 18 months, mean IOP reduction of at least 2 mmHg was 4.8mmHg (2 -16). The mean number of drops preoperatively, 2.6, was reduced over 18 months to 1.0. 2 patients required additional drops with 1 patient being restarted on a single medication. One of the iStents was noted to be malpositioned. 3 patients iStent insertion was abandoned on the day due to poor visibility of trabecular meshwork.


In our study combined phacoemulsification with iStent insertion in patients with mild to moderate open angle glaucoma resulted not only in better IOP control but also in reduction of medications required for IOP control. An OHTS study showed a mean reduction in IOP of 4.1mmHg. Our study demonstrated IOP reduction of 4.8 mmHg in addition to reduction of glaucoma medications by over 50% over 18 months follow up period. There were no cases of hypotony, choroidal effusion or flat anterior chamber. Patients are still being followed up as all have not yet completed 2 years follow up

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