March 14, 2019
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iStent reduced IOP and medications through 5 years

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A cohort of patients with open-angle glaucoma or ocular hypertension implanted with an iStent after cataract surgery experienced reduced, safe and durable IOP and reduced medications through 5 years after the procedure, according to a study.

“Implantation of a single iStent during small-incision cataract surgery treating elevated IOP by ocular hypertension or POAG is a sustained, safe and effective surgical glaucoma treatment through 5 years postoperative. The majority of our patients love this very special ‘dropless’ comfort knowing that their IOP is controlled by the iStent when we perform glaucoma screenings three to four times a year,” Tobias H. Neuhann, MD, lead study author, told Healio.com/OSN.

The prospective, nonrandomized consecutive case series included 65 eyes of 43 patients with open-angle glaucoma or ocular hypertension. One iStent (Glaukos) was implanted after cataract surgery, and patients were followed for 5 years. Twenty-six eyes completed all 5 years of follow-up.

At 5 years, the mean IOP decreased by 38% to 14.7 mm Hg compared with 23.7 mm Hg preoperatively. In addition, at year 5, 92% of eyes had a mean IOP of 18 mm Hg or lower and 65% had an IOP of 15 mm Hg or lower.

The average medication reduction was 75%, with patients taking 0.5 medications at 5-year follow-up compared with two medications preoperatively. Only 4% of patients remained on three to four medications at 5 years, reduced from 28% preoperatively. Also, 69% of eyes became medication-free compared with 5% preoperatively.

Over the 5-year follow-up, no sight-threatening or device-related adverse events occurred.

Corrected distance visual acuity was preserved at 5 years, with a mean of 20/40 or better in 100% of 24 eyes and 20/25 or better in 79% of 24 eyes. – by Robert Linnehan

Disclosures: Neuhann reports he is paid for presentations by Staar Surgical and Bausch + Lomb. Hornbeak and Giamporcaro report they are employees of Glaukos.