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Initial clinical results after implantation of 2nd generation trabecular micro-bypass stents in a combined cataract and glaucoma procedure

Poster Details

First Author: K.Gundersen NORWAY

Co Author(s):                        

Abstract Details


To evaluate single surgeon’s clinical results of the first 20 patients treated with two 2nd generation trabecular micro-bypass stents (iStent inject (Glaukos)) for lowering intraocular pressure (IOP).


A single surgeon, single site evaluation of post-operative outcomes.


A retrospective study of the first 20 patients (36 eyes) treated with combined cataract extraction and iStent inject implantation. All subjects were followed after combined cataract extraction and iStent inject implantation. Post-operative study visits include Day 1 and Months 1, 3 and 6. Primary outcome measurement was IOP. Secondary outcome measurements were number of glaucoma medications, distance visual acuity and refraction. All complications during surgery and in the early postoperative period were recorded.


36 eyes of 20 patients were implanted with the iStent inject devices with no serious complications. Successful implantation of two iStent inject in each study eye was performed in all, but one eye. Preoperative IOP was 22.4  3.8 mmHg, reduced to 17.5  3.6 mmHg after 5 weeks. Only one eye showed an IOP spike up to 48 mmHg at the day 1 visit, but normalized on one medication. Study subjects had a mean of 2.25 glaucoma medications before surgery, reduced to 1.2 after surgery. Month 3 & 6 data will be shown in the final presentation.


Although there is a learning curve with implantation of iStent inject, all, but one case were successfully implanted. Significant lowering of IOP and reduction of glaucoma medications was achieved in this cohort. iStent implantation can be a valuable tool to reduce IOP in mild to moderate glaucoma patients with a very low risk profile. The procedure can safely be performed by an experienced cataract surgeon after a short introduction period. The main technical challenge is proper visualization of the anterior chamber angle using a surgical gonioscope recognizing the chamber angle anatomy.

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