Refractive Outcomes After Trabecular Micro-Bypass Stents (iStent Inject) with Cataract Extraction in Open-Angle...

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Cataract Surgery

Background:

• Simultaneous cataract and glaucoma surgery presents challenges for anterior segment surgeons.
• Minimally invasive glaucoma surgery (MIGS) combined with cataract surgery shows promise for lowering intraocular pressure.
• Significant visual impact from combined procedures is unexpected.

Purpose of the Study:

• To describe refractive outcomes in patients undergoing simultaneous cataract removal and iStent inject implantation.
• To discuss implications of combined surgery for patients with co-existent glaucoma.
• To evaluate the refractive neutrality of the iStent inject device.

Main Methods:

• Retrospective consecutive case series.
• Inclusion of patients undergoing femtosecond laser-assisted cataract surgery with two iStent inject trabecular micro-bypass stents.
• Analysis of visual acuity, refraction, and astigmatic vector from pre-operative and 4-week post-operative visits.

Main Results:

• 106 eyes from 89 patients were analyzed.
• Mean absolute difference from target refraction was 0.36 ± 0.25D.
• 73.9% of eyes achieved refractive targets within ± 0.5D; 98.9% within ± 1.00D.
• 73.8% of eyes had ≤ 0.5D residual refractive astigmatism.

Conclusions:

• Combined iStent inject and cataract surgery yields excellent refractive outcomes in glaucoma patients.
• The second-generation iStent inject device is refractively neutral.
• This combined approach offers favorable visual results for managing co-existent glaucoma and cataracts.