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Updated: Mar 18, 2026

E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
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Manchester iStent study: 3-year results and cost analysis.

S Z Tan1,2,3, L Au2

  • 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
PubMed
Summary

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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.

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  • 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).