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Changes in optic nerve and macular perfusion after iStent insertion in combination with phacoemulsification in patients with open-angle glaucoma: an optical coherence tomography angiography study

Poster Details

First Author: M.Alnawaiseh GERMANY

Co Author(s):    V. Mueller   L. Lahme   R. Merte   N. Eter           

Abstract Details


To evaluate changes in optic nerve and macular perfusion after the implantation of a trabecular micro-bypass stent (iStent) in combination with cataract surgery.


Dept. of Ophthalmology, University of Muenster Medical Center


48 eyes of 48 patients, who underwent either cataract surgery alone (cataract group) or cataract surgery with implantation of two iStent inject devices (iStent group), were prospectively included in this study. OCTA was performed using RTVue XR Avanti with AngioVue (Optovue Inc., Fremont, California, USA). The macula was imaged with a 3x3 mm scan and the optic nerve head (ONH) with a 4.5x4.5 mm scan. Intraocular pressure (IOP), and flow density data before and weeks after surgery were extracted and analysed.


In the iStent group the mean IOP was 18.2±3.3 mm Hg prior to surgery and 13.2 ± 2.3 at follow-up, and this difference was statistically significant (p<0.001). The mean IOP in the cataract group also improved significantly after surgery (before: 17.1±2.4; after: 15.1±2.7 p=0.003). The flow density (whole en face) in the superficial and deep retinal OCT angiogram of the macula (superficial: p=0.002; deep: p=0.034) and in the ONH (p=0.011) improved significantly after surgery in the iStent group. The differences in the cataract group were not significant.


iStent insertion in combination with cataract extraction induced a significant improvement in macular and ONH perfusion. Non-invasive quantitative analyses of flow density provide a new parameter, which can help for monitoring of therapy success after glaucoma surgery.

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