Real‑World Outcomes Of Istent Infinite With/Without Goniotomy In Predominantly Pseudophakic Poag Eyes Through Three Years

To evaluate intraocular pressure (IOP), medication burden, visual acuity, and safety following implantation of iStent infinite with or without concurrent goniotomy in eyes with primary open‑angle glaucoma (POAG).

Single‑surgeon, single‑practice cohort; prospective data collection with routine postoperative follow‑up to 36 months (clinical care setting).

Eyes receiving iStent infinite between 2022–2023 were included. Baseline demographics, diagnosis, glaucoma severity, lens status, preoperative IOP (Goldmann/Tonopen), and medications were recorded. Postoperative IOP, medications at the time of tonometry, best‑corrected visual acuity (BCVA), adverse events (AEs), and secondary procedures were collected at Day 1, Week 1, Month 1, Month 3, Month 6, Year 1, Month 18, Year 2, and Year 3. Outcomes included descriptive IOP and medication changes from baseline and AE incidence.

Seventeen POAG eyes (11 mild/4 moderate/2 severe) were treated; 94% were pseudophakic. Concomitant procedures included goniotomy in 7 eyes (41%) and anterior vitrectomy in 2 eyes (12%); 8 eyes (47%) had no concurrent procedure. Mean preop IOP was 21.7 ± 2.7 mmHg on 1.47 meds. At Year 1, mean IOP was 14.7 ± 3.4 mmHg (Δ −6.8 mmHg, −31.4%, n=15 paired); 87% achieved ≤18 mmHg and 73% ≤15 mmHg. Mean medications decreased by 1.0 (to 0.53); 73% were med‑free at Year 1. Reductions persisted (Δ −5.5 mmHg at Year 2; Δ −7.3 mmHg at Year 3; med‑free 85% and 82%, respectively). One non‑stent‑related AE occurred (Week 1); no intra‑operative complications were recorded.

In this single‑surgeon series of POAG eyes—predominantly pseudophakic—iStent infinite with or without goniotomy produced clinically meaningful and durable IOP and medication reductions through three years with a favorable safety profile. These real‑world data support MIGS as an effective option for lowering IOP and reducing drop burden in appropriately selected POAG patients.