ESCRS - O10 - OCULAR SURFACE CHANGES IN GLAUCOMA PATIENTS UNDERGOING CATARACT SURGERY COMBINED WITH MICRO INVASIVE GLAUCOMA SURGERY (2ND GENERATION ISTENT INJECT IMPLANTATION): A PROSPECTIVE STUDY ABOUT 69 EYES

OCULAR SURFACE CHANGES IN GLAUCOMA PATIENTS UNDERGOING CATARACT SURGERY COMBINED WITH MICRO INVASIVE GLAUCOMA SURGERY (2ND GENERATION ISTENT INJECT IMPLANTATION): A PROSPECTIVE STUDY ABOUT 69 EYES

Published 2023 - 27th ESCRS Winter Meeting

Reference: O10 | Type: Free Paper Submission | DOI: 10.82333/drkd-a711

Authors: Omar Bengebara* 1 , IDRISS BENATIYA ANDALOUSSI 2 , MERIEM ABDELLAOUI 2 , FOUAD CHRAIBI 2 , AHMED BENNIS 2 , MALEK SLIM 3

1OPHTHALMOLOGY,HASSAN II UNIVERSITARY HOSPITAL,FEZ,Morocco;OPHTHALMOLOGY,CENTRE HOSPITALIER JACQUES COEUR BOURGES,BOURGES,France, 2OPHTHALMOLOGY,HASSAN II UNIVERSITARY HOSPITAL,FEZ,Morocco, 3OPHTHALMOLOGY,CENTRE HOSPITALIER JACQUES COEUR BOURGES,BOURGES,France

Purpose

 
     

The purpose of this study was to evaluate ocular surface changes and dry eyes symptoms in patients undergoing cataract surgery by phacoemulsification combined with micro-invasive glaucoma surgery (Implantation of second generation iStent Inject trabecular stents).

Setting

 
 

Ophthalmology department of Bourges (Jacques Coeur Hospital), France.

Methods

 
     

This single-arm prospective interventional clinical trial enrolled 47 patients with mild-to-moderate open-angle glaucoma taking from 1 to 4 glaucoma medications that underwent phacoemulsification combined with implantation of two second generation iStent Inject trabecular stents.

We explored several key data about ocular surface and glaucoma throughout the follow-up that lasted 6 months, including the Ocular Surface Disease index score (OSDI), the Oxford corneal/conjunctival staining score, the Efron conjunctival hyperemia score, and the Fluorescein Tear Break up Time (FTBUT). We also assessed glaucoma medications and intraocular pressure (IOP) at each follow-up visit.

Results

 
     

Mean OSDI scores improved from 40.1 ± 21.6 (severe dry eye) preoperatively to 17.5 ± 15.3 (mild dry eye) at 6 months (p<0.001). While 73% of eyes had moderate or severe OSDI scores preoperatively, only 29% had such scores at 6 months. The OSDI score was normal in 57% of patients at 6 months compared with 9% preoperatively. The mean FTBUT increased from 4.3 ± 2.4 seconds preoperatively to 6.4 ± 2.5 seconds at 6 months (p<0.001). The average corneal/conjunctival Oxford staining score decreased from 1.4 ± 1.0 preoperatively to 0.4 ± 0.6 at 6 months (p<0.001) and the mean Efron conjunctival hyperemia score also decreased from 1.4 ± 0.7 preoperatively to 1.2 ± 0.6 at 6 months (p = 0.118).

Concerning glaucoma parameters, we observed a reduction in the number of glaucoma medications from 1.5 ± 0.9 to 0.6 ± 0.8 on average (60% reduction, p<0.001) with 55% of patients that were able to stop their hypotonizing eye drops. Mean IOP was reduced from 17.4 ± 4.2mmHg to 14.5 ± 3.2 mmHg at the latest follow-up (p<0.001). The safety profile of the surgery was excellent.

Conclusion

 
     

Implantation of iStent Inject trabecular stents combined with cataract surgery resulted in clinical and functional improvements in ocular surface health, as well as significant reductions in IOP and medication burden in patients with open-angle glaucoma.