Phaco + iStent implant learning curve in a teaching hospital

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Minimally Invasive Procedures

Background:

• The iStent inject W is a device for alternative aqueous humor drainage to reduce intraocular pressure (IOP).
• Existing international reports support its efficacy, but data on the early learning curve is limited.

Purpose of the Study:

• To evaluate the learning curve, safety, and efficacy of the iStent inject W during its initial implementation.
• To assess surgical time, complications, and postoperative IOP reduction in early cases.

Main Methods:

• A retrospective study of the first 6 iStent inject W implants by 6 surgeons in a tertiary hospital.
• Procedures were combined with cataract surgery (phaco + iStent inject W).
• Surgical time, complications, and IOP were monitored preoperatively and up to 90 days postoperatively.

Main Results:

• Surgical time decreased by 8.5 minutes across the learning curve for the first 36 patients.
• Mean preoperative IOP of 21.81 mmHg reduced to 16.00 mmHg at 1 month (a 26.64% decrease), with fewer medications needed.
• Trabecular meshwork hemorrhage was the most common intraoperative complication; no secondary interventions were required.

Conclusions:

• The iStent inject W procedure is perceived as a fast-learning, safe option for glaucoma management.
• The combined cataract surgery and iStent inject W approach significantly reduces IOP, offering a valuable treatment for glaucoma patients.