Comparative evaluation of iStent versus iStent inject W combined with phacoemulsification in open angle glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Medical Devices

Background:

• Open-angle glaucoma (OAG) management often requires medication and surgical interventions to control intraocular pressure (IOP).
• Minimally invasive glaucoma surgery (MIGS) offers an alternative to traditional procedures.
• The iStent and iStent inject W are MIGS devices used in conjunction with cataract surgery.

Purpose of the Study:

• To compare the 12-month post-operative outcomes of iStent and iStent inject W implantation in patients with open-angle glaucoma.
• To identify factors associated with surgical success for these MIGS devices.

Main Methods:

• A retrospective comparative case series analyzed 160 patients undergoing iStent (1 stent) or iStent inject W (2 stents) implantation with cataract surgery.
• Outcomes assessed at 12 months included intraocular pressure (IOP), glaucoma medication use, and survival analysis.
• Surgical failure was defined by IOP elevation, increased medication, insufficient IOP reduction, or need for further surgery.

Main Results:

• Treatment success was observed in 66.0% of iStent eyes and 78.4% of iStent inject W eyes at 12 months.
• Both groups showed significant IOP reduction (iStent: 8.0%; inject W: 11.9%) and decreased medication burden, with no significant between-group differences.
• Mean IOP was 13.7 mmHg for iStent and 13.8 mmHg for iStent inject W; medication burden reduced from 2.5 to 1.1 (iStent) and 2.9 to 1.7 (inject W).

Conclusions:

• Both iStent and iStent inject W are safe and effective in reducing IOP and medication requirements 12 months post-surgery in OAG patients.
• No significant differences in efficacy were found between the iStent and iStent inject W groups.
• Lower baseline IOP was identified as a predictor of surgical failure.