Phacoemulsification with and without iStent: A Systematic Review and Meta-Analysis of Comparative Studies
Francesca Kahale1, Wassef Chanbour2, Lulwa El Zein3
1Boston vision, Brookline, Massachusetts, USA.
Ophthalmic Research
|May 28, 2023
Summary
Combining iStent with phacoemulsification surgery significantly lowers intraocular pressure (IOP) and reduces the need for glaucoma eye drops compared to phacoemulsification alone. This minimally invasive glaucoma surgery offers a synergistic effect for better IOP management.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Surgical Innovation
Background:
- The iStent is a minimally invasive glaucoma device used to lower intraocular pressure (IOP).
- It can be implanted during phacoemulsification or as a standalone procedure.
- This study focuses on its use in patients with ocular hypertension or open-angle glaucoma.
Approach:
- A systematic review and meta-analysis was conducted.
- Searched EMBASE, MEDLINE, CINAHL, and Cochrane Library for studies from 2008 to June 2022.
- Compared IOP reduction and glaucoma drop decrease between iStent with phacoemulsification versus phacoemulsification alone.
Key Points:
- Ten studies involving 1,453 eyes were analyzed.
- Combined iStent and phacoemulsification showed greater IOP reduction (4.7 mmHg) than phacoemulsification alone (2.8 mmHg).
- The combined group also required fewer glaucoma drops (1.2 vs. 0.6).
Conclusions:
- iStent implantation demonstrates a synergistic effect when combined with phacoemulsification.
- This combination leads to significantly higher IOP reduction and decreased reliance on glaucoma medications.
- Newer generation iStents may offer enhanced efficacy in IOP lowering.
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