Skip to main content
Top
Published in: International Ophthalmology 1/2024

01-12-2024 | Glaucoma | Original Paper

Outcomes of iStent inject combined with cataract surgery in Asian eyes: Australian data from the Fight Glaucoma Blindness international registry

Authors: Brandon Huynh, Getiye Kibret, David Wechsler, Anne Lee, Ridia Lim, Colin Clement, Mitchell Lawlor

Published in: International Ophthalmology | Issue 1/2024

Login to get access

Abstract

Purpose

To analyse real-world outcomes in Asian eyes of iStent inject, a second-generation trabecular micro-bypass stent, combined with phacoemulsification.

Methods

This is a multi-centre, observational study of glaucomatous Asian eyes that have undergone iStent inject implantation combined with cataract surgery. Patient data were extracted from the Fight Glaucoma Blindness! Registry. Outcome measures included those of IOP reduction, glaucoma medication reduction, and adverse events including the need for secondary surgery.

Results

123 eyes of 86 patients with a mean age of 68.4 ± 9.3 years underwent iStent inject implantation with phacoemulsification. At baseline, the mean ± SD preoperative intraocular pressure (IOP) was 16.0 ± 4.4 mmHg, and the mean preoperative number of topical glaucoma medications was 1.9 ± 1.4. At 12 months 30.8% of eyes demonstrated a reduction in IOP greater than 20%, the mean IOP reduction was 12.5% with an additional reduction of 0.7 glaucoma medications. 40% of eyes were using no medications at 12 months compared to 16.3% preoperatively. 8.2% of eyes required a subsequent procedure within the 12-month follow-up window.

Conclusion

iStent inject implantation combined with phacoemulsification in Asian eyes showed a reduction of IOP and glaucoma medication use in a real-world clinical setting. The safety profile of the device is good with minimal adverse outcomes, however, a subset of patients required secondary procedures within the 12 month follow up.
Literature
1.
go back to reference Ang BCH, Chiew W, Yip VCH et al (2022) Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma. Eye Vis (Lond) 9:27CrossRefPubMed Ang BCH, Chiew W, Yip VCH et al (2022) Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma. Eye Vis (Lond) 9:27CrossRefPubMed
2.
go back to reference Ang BCH, Tecson I, Hu JYW et al (2022) 12-Month outcomes of combined phacoemulsification and iStent inject in Asian eyes with normal tension glaucoma: a single-centre experience. Int Ophthalmol 42:611–620CrossRefPubMed Ang BCH, Tecson I, Hu JYW et al (2022) 12-Month outcomes of combined phacoemulsification and iStent inject in Asian eyes with normal tension glaucoma: a single-centre experience. Int Ophthalmol 42:611–620CrossRefPubMed
3.
go back to reference Clement CI, Howes F, Ioannidis AS et al (2019) One-year outcomes following implantation of second-generation trabecular micro-bypass stents in conjunction with cataract surgery for various types of glaucoma or ocular hypertension: multicenter, multi-surgeon study. Clin Ophthalmol 13:491–499CrossRefPubMedPubMedCentral Clement CI, Howes F, Ioannidis AS et al (2019) One-year outcomes following implantation of second-generation trabecular micro-bypass stents in conjunction with cataract surgery for various types of glaucoma or ocular hypertension: multicenter, multi-surgeon study. Clin Ophthalmol 13:491–499CrossRefPubMedPubMedCentral
5.
go back to reference Heijl A, Leske MC, Bengtsson B et al (2002) Reduction of intraocular pressure and glaucoma progression: results from the early manifest glaucoma trial. Arch Ophthalmol 120:1268–1279CrossRefPubMed Heijl A, Leske MC, Bengtsson B et al (2002) Reduction of intraocular pressure and glaucoma progression: results from the early manifest glaucoma trial. Arch Ophthalmol 120:1268–1279CrossRefPubMed
6.
go back to reference Hengerer FH, Auffarth GU, Conrad-Hengerer I (2022) iStent inject trabecular micro-bypass with or without cataract surgery yields sustained 5-year glaucoma control. Adv Ther 39:1417–1431CrossRefPubMedPubMedCentral Hengerer FH, Auffarth GU, Conrad-Hengerer I (2022) iStent inject trabecular micro-bypass with or without cataract surgery yields sustained 5-year glaucoma control. Adv Ther 39:1417–1431CrossRefPubMedPubMedCentral
7.
go back to reference Hu Yw J, Ang ChB, Tecson IOC et al (2022) Combined phacoemulsification and iStent inject implantation in Asian eyes. Eur J Ophthalmol 32:288–295CrossRefPubMed Hu Yw J, Ang ChB, Tecson IOC et al (2022) Combined phacoemulsification and iStent inject implantation in Asian eyes. Eur J Ophthalmol 32:288–295CrossRefPubMed
8.
go back to reference Inatani M, Kohama I, Chu A (2022) iStent trabecular micro-bypass stent implantation combined with phacoemulsification for open-angle glaucoma: a 2-year post-marketing surveillance study in Japan. Adv Ther 39:4076–4093CrossRefPubMedPubMedCentral Inatani M, Kohama I, Chu A (2022) iStent trabecular micro-bypass stent implantation combined with phacoemulsification for open-angle glaucoma: a 2-year post-marketing surveillance study in Japan. Adv Ther 39:4076–4093CrossRefPubMedPubMedCentral
9.
go back to reference Kumar D, Klefsjö B (1994) Proportional hazards model: a review. Reliab Eng Syst Saf 44:177–188CrossRef Kumar D, Klefsjö B (1994) Proportional hazards model: a review. Reliab Eng Syst Saf 44:177–188CrossRef
10.
go back to reference Lawlor EA (2021) Efficient capture of high-quality real-world data on treatments for glaucoma: The Fight Glaucoma Blindness Registry. BMJ Open Ophthalmol 6:e000903 (In press)CrossRefPubMedPubMedCentral Lawlor EA (2021) Efficient capture of high-quality real-world data on treatments for glaucoma: The Fight Glaucoma Blindness Registry. BMJ Open Ophthalmol 6:e000903 (In press)CrossRefPubMedPubMedCentral
11.
go back to reference Lawlor M, Nguyen V, Brooks A et al (2021) Efficient capture of high-quality real-world data on treatments for glaucoma: The Fight Glaucoma Blindness! Registry. BMJ Open Ophthalmol 6:e000903CrossRefPubMedPubMedCentral Lawlor M, Nguyen V, Brooks A et al (2021) Efficient capture of high-quality real-world data on treatments for glaucoma: The Fight Glaucoma Blindness! Registry. BMJ Open Ophthalmol 6:e000903CrossRefPubMedPubMedCentral
12.
go back to reference Leske MC, Heijl A, Hussein M et al (2003) Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol 121:48–56CrossRefPubMed Leske MC, Heijl A, Hussein M et al (2003) Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol 121:48–56CrossRefPubMed
13.
go back to reference Manning D (2019) Real-world case series of iStent or iStent inject trabecular micro-bypass stents combined with cataract surgery. Ophthalmol Ther 8:549–561CrossRefPubMedPubMedCentral Manning D (2019) Real-world case series of iStent or iStent inject trabecular micro-bypass stents combined with cataract surgery. Ophthalmol Ther 8:549–561CrossRefPubMedPubMedCentral
15.
go back to reference Rho S, Lim SH (2021) Clinical outcomes after second-generation trabecular microbypass stents (iStent inject(R)) with phacoemulsification in Korean Patients. Ophthalmol Ther 10:1105–1117CrossRefPubMedPubMedCentral Rho S, Lim SH (2021) Clinical outcomes after second-generation trabecular microbypass stents (iStent inject(R)) with phacoemulsification in Korean Patients. Ophthalmol Ther 10:1105–1117CrossRefPubMedPubMedCentral
16.
go back to reference Salimi A, Lapointe J, Harasymowycz P (2019) One-Year outcomes of second-generation trabecular micro-bypass stents (iStent Inject) implantation with cataract surgery in different glaucoma subtypes and severities. Ophthalmol Ther 8:563–575CrossRefPubMedPubMedCentral Salimi A, Lapointe J, Harasymowycz P (2019) One-Year outcomes of second-generation trabecular micro-bypass stents (iStent Inject) implantation with cataract surgery in different glaucoma subtypes and severities. Ophthalmol Ther 8:563–575CrossRefPubMedPubMedCentral
17.
go back to reference Samuelson TW, Chang DF, Marquis R et al (2019) A schlemm canal microstent for intraocular pressure reduction in primary open-angle glaucoma and cataract: the HORIZON study. Ophthalmology 126:29–37CrossRefPubMed Samuelson TW, Chang DF, Marquis R et al (2019) A schlemm canal microstent for intraocular pressure reduction in primary open-angle glaucoma and cataract: the HORIZON study. Ophthalmology 126:29–37CrossRefPubMed
18.
go back to reference Samuelson TW, Sarkisian SR Jr, Lubeck DM et al (2019) Prospective, randomized, controlled pivotal trial of an Ab interno implanted trabecular micro-bypass in primary open-angle glaucoma and cataract: two-year results. Ophthalmology 126:811–821CrossRefPubMed Samuelson TW, Sarkisian SR Jr, Lubeck DM et al (2019) Prospective, randomized, controlled pivotal trial of an Ab interno implanted trabecular micro-bypass in primary open-angle glaucoma and cataract: two-year results. Ophthalmology 126:811–821CrossRefPubMed
19.
go back to reference Shaarawy T, Sherwood M, Grehn F (2009) World Glaucoma Association guidelines on design and reporting of glaucoma surgical trials. Kugler, Amsterdam Shaarawy T, Sherwood M, Grehn F (2009) World Glaucoma Association guidelines on design and reporting of glaucoma surgical trials. Kugler, Amsterdam
20.
go back to reference Sihota R, Angmo D, Ramaswamy D et al (2018) Simplifying “target” intraocular pressure for different stages of primary open-angle glaucoma and primary angle-closure glaucoma. Indian J Ophthalmol 66:495–505CrossRefPubMedPubMedCentral Sihota R, Angmo D, Ramaswamy D et al (2018) Simplifying “target” intraocular pressure for different stages of primary open-angle glaucoma and primary angle-closure glaucoma. Indian J Ophthalmol 66:495–505CrossRefPubMedPubMedCentral
21.
go back to reference Tham YC, Li X, Wong TY et al (2014) Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 121:2081–2090CrossRefPubMed Tham YC, Li X, Wong TY et al (2014) Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 121:2081–2090CrossRefPubMed
22.
go back to reference Therneau TM, Lumley T (2015) Package ‘survival.’ R Top Doc 128:28–33 Therneau TM, Lumley T (2015) Package ‘survival.’ R Top Doc 128:28–33
23.
go back to reference Therneau TM, Therneau MTM (2015) Package ‘coxme’. R package version 2 Therneau TM, Therneau MTM (2015) Package ‘coxme’. R package version 2
Metadata
Title
Outcomes of iStent inject combined with cataract surgery in Asian eyes: Australian data from the Fight Glaucoma Blindness international registry
Authors
Brandon Huynh
Getiye Kibret
David Wechsler
Anne Lee
Ridia Lim
Colin Clement
Mitchell Lawlor
Publication date
01-12-2024
Publisher
Springer Netherlands
Keywords
Glaucoma
Cataract
Published in
International Ophthalmology / Issue 1/2024
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-024-03104-x

Other articles of this Issue 1/2024

International Ophthalmology 1/2024 Go to the issue