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Manchester iStent study: 3-year results and cost analysis
1Centre for Ophthalmology and Vision Sciences, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK.
Eye (London, England)
|July 9, 2016
Summary
Combined phaco-iStent implantation is a safe and effective treatment for open-angle glaucoma (OAG), significantly reducing intraocular pressure and medication needs over three years. Cost-effectiveness varies based on medication type.
Area of Science:
- Ophthalmology
- Glaucoma Management
- Surgical Innovation
Background:
- Open-angle glaucoma (OAG) requires long-term management to prevent vision loss.
- Cataract surgery presents an opportunity for concurrent glaucoma treatment.
- Intraocular pressure (IOP) reduction is critical in OAG management.
Purpose of the Study:
- To assess the safety, efficacy, and cost-effectiveness of combined phacoemulsification and single iStent insertion in OAG patients.
- To evaluate outcomes at a 3-year follow-up interval.
- To compare the procedure's cost against traditional glaucoma medication management.
Main Methods:
- Prospective, uncontrolled, interventional case series.
- Single surgeon performed combined phaco-iStent implantation in 41 OAG patients.
- Primary outcomes: IOP reduction and glaucoma drop count at 1, 2, and 3 years.
Main Results:
- Mean IOP reduced from 21.2 mmHg pre-operatively to 17.1 mmHg at 3 years (P<0.001).
- Average glaucoma medication use decreased from 2.1 to 1.3 drops at 3 years.
- Combined procedure cost was higher than conservative management, with cost-effectiveness dependent on medication pricing.
Conclusions:
- Combined phaco-iStent implantation is a safe and effective treatment for OAG over 3 years.
- The procedure demonstrates significant IOP and medication reduction.
- Cost-effectiveness analysis suggests variability based on eye drop costs (brand vs. generic).
