Usage Of Three Trabecular Micro-Bypass Stents Combined With Phacoemulsification In Surgically Naive Glaucoma Patients

To evaluate the IOP- and medication-lowering efficacy of third-generation trabecular micro-bypass (iStent infinite, containing 3 iStent inject W stents) in combination with phacoemulsification in patients with mild-to-severe glaucoma.

Private ophthalmology practice in the United States.

Retrospective case series of 24 eyes of 18 patients with no prior glaucoma surgery that underwent iStent infinite implantation at the time of phacoemulsification from December 2022 through June 2023. Follow-up visits were conducted at 1 day, 1 week, and 1-, 3-, 6-, and 12-months postoperatively. Glaucoma severity was mild and moderate in 54.1% and 41.6% of eyes, respectively. Outcomes included mean & percent change in intraocular pressure (IOP), number of medications, and adverse events (AEs). Statistical significance between two timepoints was calculated by paired Student’s t-test.

IOP was significantly reduced from a baseline of 17.3 ± 4.5 mmHg to 14.4 ± 4.6 mmHg (p < 0.01) within one month of surgery and remained significantly low at 3 months (13.3 ± 3.2 mmHg, n = 15) (p < 0.005) and at 6 months postoperatively (though at the time of abstract writing only three patients had reached 6 months). Medication burden was also significantly reduced from 1.1 ± 0.4 at baseline to 0.3 ± 0.6 at one month and 0.4 ± 0.6 at three months (p < 0.0005 at both timepoints). No intraoperative complications were noted. Post-op AEs including slight corneal edema and subconjunctival hemorrhage had all resolved by one-week post-op, and no new AEs were observed during the remaining follow-up.

The iStent infinite significantly lowered IOP and medication burden in glaucoma patients who had no previous surgical intervention or SLT.