Outcomes Of Istent Versus Endocyclophotocoagulation As Adjunct To Cataract Surgery By Phacoemulsification For Treating Open Angle Glaucoma
Published 2023 - 41st Congress of the ESCRS
Reference: PP18.12 | Type: Free paper | DOI: 10.82333/j2v2-vb37
Authors: Rakan Algorinees* 1 , Asma Almohizea 2 , Ibrahim Alobaida 2 , Konrad Schargel 2 , Hind Aldalgan 3
1King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia;Department of ophthalmology,University of Ha'il,Ha'il,Saudi Arabia, 2King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia, 3Department of ophthalmology,Imam Abdulrahman bin Faisal university,Al Khobar,Saudi Arabia
Purpose
To compare the efficacy and safety of iStent versus Endocyclophotocoagulation (ECP) as an adjunct to cataract surgery by Phacoemulsification for treating open-angle glaucoma in a tertiary eye center.
Setting
King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
Methods
A retrospective two-armed cohort study of 67 eyes of 61 patients with open-angle glaucoma and cataract who underwent either phaco-ECP or phaco-iStent in the period between January 2016 to December 2019. The primary efficacy endpoint is the Intraocular pressure (IOP) reduction, while the reduction of glaucoma medications is the secondary outcome. In addition, visual acuity (LogMAR), IOP, degree of disc cupping, and the number of glaucoma medications were evaluated at baseline, day 1, months 1, 3, 6, and 12 postoperatively. Safety profiles were assessed as well.
Results
A total of 40 eyes underwent phaco-ECP, and 27 eyes underwent phaco-iStent. Both groups were associated with a significant reduction in the number of glaucoma medications; however phaco-iStent group achieved slightly lower IOP levels than the phaco-ECP group. Furthermore, iStent inject had better control of IOP at the last follow-up compared to first-generation stents. Moreover; 2 or more stents significantly reduced IOP than single stent (p=0.009 vs. p=0.618, respectively). Phaco-iStent achieved a better reduction in the number of glaucoma medications for primary open-angle glaucoma (p=0.007) compared to pseudoexfoliation glaucoma patients (p=0.084). Complications were seen in 14 eyes (20.8%), majority were mild and treated conservatively.
Conclusions
Phaco-iStent seems superior in reducing IOP after 1 year of follow-up compared to phaco-ECP, particularly when 2 or more stents are used. However, both groups had equal efficacy in reducing the number of glaucoma medications, and both showed an overall good safety profile.