gms | German Medical Science

Purpose: This study aims to evaluate and compare intraocular pressure (IOP) change and number of topical IOP-lowering medications after combined cataract surgery with iStent inject^® implantation versus cataract surgery alone in patients with open-angle glaucoma.

Methods: Retrospective comparative chart review of 150 patients (150 eyes) with different types of open-angle glaucoma, who were naïve to any previous ocular procedure and underwent combined cataract surgery with iStent^® implantation (100 eyes) or cataract surgery alone (50 eyes), was performed. Study outcomes were median IOP change and the mean number of topical IOP-lowering medications at 3, 6 and 12 months after surgery.

Results: The median IOP change in the study group at 3, 6 and 12 months follow up was -4 (-6 to -2) mmHg (p<0.001), -4 (-6 to -1) mmHg (p<0.001), and -4 (-6.75 to -2) mmHg (p<0.001), respectively. The median IOP change in the control group at 6 and 12 months follow up was 1 (-1 to 3) mmHg, and 0 (-2.5 to 3) mmHg, respectively. Thus, IOP reduction in the study group was statistically significantly larger (p<0.001), than in the control group at 3 months (-5.97), 6 months (-4.63), and 12 months (-5.24) follow up, respectively. We found a statistically significant reduction in the mean number of topical IOP-lowering medications at 12 months after combined surgery (1.08±0.8 vs. 1.23±0.8; p<0.001), while control group showed no reduction in preoperative medications.

Conclusions: This study shows a statistically significant IOP change and reduction of topical IOP-lowering medications at 12 months follow-up after combined cataract surgery with iStent^® implantation compared to cataract surgery alone in glaucoma patients.