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Open Angle Glaucoma: Treatment01:27

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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, 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 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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Related Experiment Video

Updated: Oct 23, 2025

Author Spotlight: A Novel Protocol for Intracameral Injections to Enhance Precision in Rodent Ophthalmology
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iStent versus iStent inject implantation combined with phacoemulsification in open angle glaucoma.

Wesam Shamseldin Shalaby1, Sophia S Lam2, Amirmohsen Arbabi3

  • 1Glaucoma Research Center, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA; Tanta Medical School, Tanta University, Tanta, Gharbia, Egypt.

Indian Journal of Ophthalmology
|August 24, 2021
PubMed
Summary

The iStent inject device demonstrated lower intraocular pressure (IOP) and a higher proportion of patients achieving target IOP compared to the iStent. However, both glaucoma surgeries showed similar long-term success rates.

Keywords:
iStentiStent injectminimally invasive glaucoma surgeryopen angle glaucomaphacoemulsificationtrabecular microbypass stent

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Medical Devices

Background:

  • Open-angle glaucoma is a leading cause of irreversible blindness.
  • Minimally invasive glaucoma surgery (MIGS) offers an alternative to traditional treatments.
  • The iStent and iStent inject are commonly used MIGS devices implanted during cataract surgery.

Purpose of the Study:

  • To compare the clinical outcomes of iStent versus iStent inject implantation combined with phacoemulsification.
  • To evaluate differences in intraocular pressure (IOP) reduction, medication usage, and surgical success rates between the two devices.

Main Methods:

  • A single-center, retrospective comparative case series.
  • Included patients with open-angle glaucoma undergoing iStent or iStent inject implantation with phacoemulsification.
  • Follow-up of at least one year, assessing IOP, medication count, and surgical success (20% IOP reduction).

Main Results:

  • Both iStent and iStent inject groups showed significant IOP and medication reduction.
  • iStent inject achieved lower IOP at 6 months and a higher proportion of eyes reaching IOP ≤15 mmHg at 6 and 12 months.
  • Surgical success and 1-year cumulative failure rates were comparable between the two groups.

Conclusions:

  • iStent inject offers early IOP advantages over iStent, with more eyes achieving target IOP.
  • Long-term surgical success and failure rates are similar for both MIGS devices.
  • Older age and lower baseline IOP, not stent type, are key predictors of surgical failure.