iStent inject reduces IOP, medication burden at 36 months

Patients implanted with two iStent injects after cataract surgery experienced reduced IOP and less reliance on medications after 36 months, according to a study.

The prospective, nonrandomized, consecutive case series study included 81 eyes of patients with predominantly primary open-angle glaucoma or pseudoexfoliative glaucoma who underwent cataract surgery and were implanted with two iStent injects (Glaukos). Fifty-six percent of eyes were on three to four medications preoperatively, and one eye was medication-free. Approximately 32% of eyes had previously undergone glaucoma surgery. The mean preoperative IOP of the study cohort was 22.6 mm Hg.

At 36 months, the mean IOP of the study eyes was reduced by 37% to 14.3 mm Hg. The mean medication burden was reduced from 2.5 medications preoperatively to 0.8 medications. Additionally, 54% of eyes were medication-free compared with 1% preoperatively; 2% of eyes were on three or more medications at 36 months.

Because more patients completed the 12-month follow-up than the 36-month follow-up, subgroup analyses were conducted at 12 months. In eyes with primary-open angle glaucoma, IOP decreased by 33% and medication burden decreased by 68% at 12 months. Eyes with pseudoexfoliative glaucoma experienced a 32% IOP decrease and a medication burden decrease of 64% at 12 months.

“This prospective study demonstrated substantial reductions in both IOP and medication burden through 3 years of follow-up in patients with glaucoma and cataract, along with favorable safety. Notably, these study results were achieved not only in mild to moderate glaucoma cases, but also in patients who previously were using multiple topical medications or had undergone prior glaucoma surgeries,” study co-author Fritz H. Hengerer, MD, PhD, told Healio.com/OSN. “Since these patients comprised a clinically diverse, representative, real-world patient population, the data are directly relevant to current glaucoma physicians and patients.” – by Robert Linnehan

Disclosures: Hengerer reports he has received travel support, research grants and lecture fees from Glaukos. Please see the study for all other authors’ relevant financial disclosures.

Editor's note: This article has been updated to include author comment from Fritz J. Hengerer, MD, PhD.