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iStent inject with phaco yields clinically significant IOP reduction

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Thomas w. Samuelson

WASHINGTON — Patients who received an iStent inject with phacoemulsification experienced clinically significant reductions in unmedicated diurnal IOP compared with patients who underwent phacoemulsification alone, according to 24-month study results.

The prospective, randomized, controlled trial included 387 patients with mild to moderate open-angle glaucoma who received the iStent inject (Glaukos) and underwent phacoemulsification and 118 patients who underwent phacoemulsification alone.

According to a company press release, “The iStent inject is designed to improve aqueous humor outflow into Schlemm’s canal and reduce IOP in mild to moderate open-angle glaucoma patients undergoing cataract surgery. It includes two heparin-coated titanium stents preloaded into an autoinjection system that allows the surgeon to inject stents into multiple trabecular meshwork locations through a single corneal entry point.”

The two stents were implanted successfully in 98.7% of patients in the inject group, Thomas W. Samuelson, MD, said at the American Society of Cataract and Refractive Surgery annual meeting.

“The iStent inject subjects achieved clinically significant reduction in unmedicated diurnal IOP. At 24 months, unmedicated IOP was 17.1 mm Hg in the iStent inject group. That’s quite comparable to other MIGS [randomized controlled trials] or better than some,” Samuelson said.

The study met both primary and secondary effectiveness endpoints, achieving a clinically significant reduction in unmedicated diurnal IOP and exhibiting a high safety profile similar to cataract surgery alone, he said.

Inject group patients needed 50% fewer medications than phacoemulsification-alone patients at month 23, Samuelson said. – by Robert Linnehan

Reference:

Samuelson TW. Prospective, randomized, multicenter clinical investigation of the Glaukos iStent inject. Presented at: American Society of Cataract and Refractive Surgery annual meeting; April 13-17, 2018; Washington.

Disclosure: Samuelson reports he is a consultant for and has an investment interest in Glaukos.