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Related Experiment Video

Updated: Jun 17, 2025

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One-Year comparative analysis between standalone iStent implantation versus combined iStent implantation with

Phong Yue Khoo1, Seng Fai Tang1,2, Chenshen Lam1

  • 1Department of Ophthalmology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.

European Journal of Ophthalmology
|August 7, 2024
PubMed
Summary

This study found that both standalone and combined iStent procedures safely lower intraocular pressure (IOP) in open-angle glaucoma (OAG) patients over 12 months. However, no significant difference in overall surgical success was observed between the two iStent implantation methods.

Keywords:
IStentefficacy and safetyintraocular pressureopen-angle glaucomaphacoemulsification

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Area of Science:

  • Ophthalmology
  • Glaucoma Management
  • Surgical Innovation

Background:

  • Open-angle glaucoma (OAG) is a leading cause of irreversible blindness worldwide.
  • Effective management strategies are crucial to lower intraocular pressure (IOP) and prevent optic nerve damage.
  • Minimally invasive glaucoma surgery (MIGS) offers an alternative to traditional treatments.

Purpose of the Study:

  • To assess the real-world effectiveness and safety of the iStent device.
  • To compare standalone iStent implantation versus iStent combined with phacoemulsification in OAG patients.
  • To evaluate long-term IOP reduction and medication usage post-implantation.

Main Methods:

  • Retrospective observational study of OAG patients undergoing standalone or combined iStent procedures.
  • Inclusion criteria: age >18, open angle on gonioscopy; Exclusion criteria: prior incisional glaucoma surgery, <6 months follow-up.
  • Primary outcome: surgical success at one year. Secondary outcomes: IOP reduction, medication use.

Main Results:

  • 48 eyes included (44 primary OAG, 4 secondary OAG); 19 standalone, 29 combined procedures.
  • Overall surgical success at one year was 31.3%. Qualified success was higher in the combined group (62.5%) vs. standalone (27.3%), though not statistically significant (p=0.239).
  • Mean IOP reduction at 24 months was 2.2 mmHg (standalone) vs. 3.3 mmHg (combined). Medication use decreased significantly in both groups (p<0.001). Two cases of stent occlusion reported.

Conclusions:

  • Both standalone and combined iStent implantation are safe procedures for IOP reduction in OAG patients up to 12 months.
  • No statistically significant difference in surgical success rates was found between standalone and combined iStent implantation.
  • Further research may be needed to identify patient subgroups who benefit most from each approach.