Assessing The Efficacy And Safety Of Istent Inject In A High-Volume Cataract Practice At A Tertiary Care Unit: A Comprehensive Study Of Outcomes.

This study aims to evaluate the effectiveness and safety of iStent Inject® in a high-volume cataract practice at a tertiary care unit.

Tertiary care setting 

We analyzed patients who underwent the iStent inject® procedure at Sunderland Eye Infirmary in the United Kingdom from January 2021 to June 2023, excluding those with less than three months of follow-up. The same surgeon performed a combined Phaco+iStent inject procedure on all patients during a typical high-volume cataract surgery list with around 10 cases per list. The main outcome measured the percentage reduction in intraocular pressure (IOP), with secondary outcomes including decreased eye drop usage, improved visual acuity, surgical complications, and the need for additional procedures. iStent inject® positioning was confirmed through gonioscopy during surgery and follow-up examinations.

The study included 60 eyes from 48 patients with an average follow-up of 13.2 ± 7.5 months. Post-surgery, mean IOP decreased from 22.2 ± 4.5 mmHg to 16.2 ± 3.7 mmHg, showing a 27.5% reduction (p = 0.006). 68.3% of eyes maintained a 20% or more IOP reduction without additional interventions. Medication burden slightly decreased from 2.3 ± 0.9 to 2.2 ± 1.0 (p = 0.08). BCVA significantly improved from 62.8 ± 12.1 to 77.1 ± 9.6 (P < 0.0001). No surgery complications were reported, with only one case of post-operative cystoid macular edema successfully treated. Two patients later underwent Trabeculectomy, and two received PreserFlo® MicroShunt for progressive glaucoma.

Our study proves that iStent inject reduces IOP safely and effectively. It can be easily incorporated into high-volume cataract surgeries delivering positive results with efficient execution.