Mid-Term Outcomes Of Combined Cataract Surgery And Istent Inject W
Published 2025 - 43rd Congress of the ESCRS
Reference: PO1008 | Type: Poster | DOI: 10.82333/4rp2-kf43
Authors: Emanuel Sampaio Fernandes* 1 , Afonso Lima Cabrita 1 , Bruno Guerreiro Dias 1 , Susana Rebocho Duarte 1 , André Barata 1 , Luís Abegão Pinto 1 , Rafael Correia Barão 1
1Serviço de Oftalmologia,Hospital de Santa Maria – Unidade Local de Saúde Santa Maria,Lisboa,Portugal
Purpose
The iStent Inject W® (Glaukos, USA) is a minimally invasive glaucoma surgery (MIGS) device designed to reduce intraocular pressure (IOP) by bypassing the trabecular meshwork and accessing the Schlemm’s canal in patients with open-angle glaucoma. This study aims to evaluate the efficacy, safety, and complication rates associated with the procedure.
Setting
A retrospective analysis was conducted on consecutive patients who underwent combined phacoemulsification and iStent Inject W implantation on a tertiary care hospital, Hospital de Santa Maria – Unidade Local de Saúde Santa Maria, in Lisbon.
Methods
The outcomes assessed included IOP and the number of glaucoma medications (NGM) at 6, 12, and 24 months. Survival analysis was performed using the Kaplan-Meier method. Surgical success was defined as IOP < 21 mmHg with a ≥ 20% reduction from baseline at 6, 12, and 24 months, regardless of the NGM. Complications and adverse events were also documented.
Results
A total of 69 eyes were included in the study, with a mean postoperative follow-up period of 7.12 months. Fourteen (20%) eyes were followed for 24 months. Mean IOP and NGM were significantly reduced at all time points.
The preoperative mean IOP decreased from 19.50 ± 4.26 mmHg to 14.57 ± 3.20 mmHg at 24 months (p < 0.01).
The mean NGM decreased from 2.07 ± 1.00 to 1.07 ± 0.92 at 24 months (p < 0.01).
We recorded 12 cases of post-operative hyphema but resolved spontaneously within 1 week without causing any hypertensive spikes.
Surgical success was achieved in 68% of patients at 6 months, 33% at 12 months, and 33% at 24 months.
Conclusions
Combining phacoemulsification with iStent Inject W® is a safe and effective procedure that improves visual acuity, reduces IOP, and significantly lowers the medication burden in patients with mild to moderate glaucoma.