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Related Concept Videos

Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Angle Closure Glaucoma: Treatment01:28

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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Glaucoma: Overview01:25

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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Standalone iStent Trabecular Micro-bypass Glaucoma Surgery: A Systematic Review and Meta-Analysis.

Paul R Healey1, Colin I Clement2, Nathan M Kerr3

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Standalone iStent glaucoma surgery effectively lowers intraocular pressure (IOP) and reduces medication needs for open-angle glaucoma (OAG) patients. This minimally invasive procedure demonstrates sustained IOP control and a favorable safety profile over several years.

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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.