iStent inject as a reasonable alternative procedure following failed trabeculectomy?

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Innovation

Background:

• Glaucoma patients with uncontrolled intraocular pressure (IOP) after trabeculectomy often require alternative treatment strategies.
• The iStent inject is a minimally invasive device designed to reduce IOP.

Purpose of the Study:

• To evaluate the IOP-lowering effect of the iStent inject in patients with uncontrolled glaucoma following a failed trabeculectomy.
• To assess the performance of glaucoma therapy with iStent inject in this patient population.

Main Methods:

• A retrospective study involving 22 eyes of 21 glaucoma patients with uncontrolled IOP post-trabeculectomy.
• IOP and the number of antiglaucomatous medications were recorded preoperatively and at multiple time points up to 1 year post-surgery.

Main Results:

• A significant reduction in IOP was observed, decreasing from a mean of 22.5 mmHg preoperatively to 15.5 mmHg at 1 year (p=0.012).
• The number of glaucoma medications showed a non-significant reduction from 2.6 to 2.25 after 1 year (p>0.05).
• No significant intraoperative or postoperative complications were reported.

Conclusions:

• The iStent inject provides effective IOP reduction in advanced open-angle glaucoma patients with prior failed trabeculectomy.
• Continued glaucoma therapy is essential for achieving target IOP and preventing disease progression.
• A 27.3% failure rate necessitates careful patient selection for iStent inject implantation.