Functional And Structural Changes After Istent Inject Implantation Using Spectral Domain Optical Coherence Tomography
Published 2023 - 41st Congress of the ESCRS
Reference: PO0857 | Type: Free paper | DOI: 10.82333/ewpd-f133
Authors: javier garcia-bella* 1 , Laura Morales-Fernandez 1 , jose maria martinez-de-la-casa 1 , julian garcia feijoo 1
1hospital clinico san carlos,Madrid,Spain
Purpose
To analyze the long-term efficacy and changes in visual field mean deviation (MD) and circumpapillary retinal nerve fibre layer (cpRNFL) thickness after iStent inject implantation (Glaukos Corporation, Laguna Hills, CA) combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma.
Setting
Minimally invasive glaucoma surgeries (MIGS) involve a group of glaucoma surgeries with some advantages such as low rate of complications and a good response of intraocular pressure control after surgery. Several studies reported istent´s effect on intraocular presure and complications after surgery however few information is available about functional and structural changes after istent implantation.
Methods
A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma and cataract. Patients underwent cataract surgery along with the implant of two iStent inject devices. Outcome measures were Intraocular pressure (IOP), amount of IOP-lowering medication, mean deviation (MD) using static Octopus and cpRNFL thickness were evaluated before during at least the first 24 months after surgery.
Results
26 patients were enrolled. Mean follow-up was 36.4 ± 10.46 months. Mean baseline IOP was 18.95 ± 3.71 mmHg with medication and mean end-follow-up IOP was 15.26 ± 1.98 mmHg. The mean number of medications was significantly reduced from 1.3 ± 0.66 to 0.75 ± 0.79 (
P = 0.017). 28% of patients were medication-free by the end of follow-up. Mean deviation remain stable at the end of the follow up (5.81 ± 3.7 to 5.23 ± 2.8 dB;
p= 0.541) meanwhile significant thinning on cpRNFL thickness was observed (85.90 ± 4.45 to 75.50 ± 6.50 microns;
p= 0.001).
Conclusions
The iStent inject device combined with cataract surgery served to significantly reduce both IOP and medication use in the long term in patients with coexistent open-angle glaucoma and cataract, and to prevent functional glaucoma progression. However, changes on cpRNFL thickness are observable using OCT even with good IOP control.