Standalone iStent Trabecular Micro-bypass Glaucoma Surgery: A Systematic Review and Meta-Analysis.

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Medical Devices

Background:

• Open-angle glaucoma (OAG) management often involves medication and surgery.
• iStent trabecular micro-bypass devices are commonly used with cataract surgery.
• Limited data exists on iStent efficacy as a standalone glaucoma procedure.

Purpose of the Study:

• To systematically evaluate the efficacy of iStent devices as a standalone procedure in OAG patients.
• To quantitatively assess intraocular pressure (IOP) reduction and medication burden changes.
• To analyze the safety profile of standalone iStent implantation.

Main Methods:

• Systematic literature review of standalone iStent procedures in OAG patients.
• Inclusion of randomized controlled trials and nonrandomized studies with adequate follow-up.
• Analysis of postoperative IOP, medication use, and adverse events.

Main Results:

• Pooled data from 13 studies (778 eyes) showed a weighted mean IOP reduction of 31.1% at 6-12 months.
• Sustained IOP reduction of approximately 6.6-7.0 mmHg observed up to 5 years.
• Medication burden decreased by 1.0-1.2 medications, with a favorable safety profile comparable to medical therapy.

Conclusions:

• Standalone iStent implantation provides significant and sustained IOP reduction in OAG.
• The procedure effectively reduces medication requirements for glaucoma patients.
• iStent devices offer a viable standalone surgical option for OAG management.