Comparative study highlights iStent superiority over ECP in glaucoma treatment
Both iStent and endocyclophotocoagulation (ECP) as an adjunct to cataract surgery effectively reduce intraocular pressure (IOP) and the number of glaucoma medications needed, but phaco-iStent demonstrates superior efficacy in reducing medication requirements, particularly when 2 ≥ stents are used, according to a study.
The retrospective study involved 67 eyes from 61 patients who underwent either phaco-ECP or phaco-iStent. The study assessed IOP, visual acuity, degree of disc cupping, and safety profiles at various intervals over a 12-month period.
Results showed that both phaco-ECP and phaco-iStent groups experienced significant reductions in the number of glaucoma medications required. However, the phaco-iStent group achieved slightly lower IOP levels compared to the phaco-ECP group. The iStent inject provided better IOP control at the last follow-up compared to first-generation stents. In addition, using 2 ≥ stents was significantly more effective in reducing IOP than using a single stent.
Phaco-iStent was particularly effective in reducing the number of glaucoma medications for patients with primary open-angle glaucoma, showing a statistically significant improvement (P = 0.007) compared to those with pseudoexfoliation glaucoma (P = 0.084).
In terms of safety, complications were observed in 7.4% of phaco-ECP cases and 10.4% of phaco-iStent cases.
Reference
Algorinees R, Almohizea A, Aldalgan H, et al. Outcomes of iStent versus endocyclophotocoagulation (ECP) as adjunct to cataract surgery by phacoemulsification for glaucoma patients. Eur J Ophthalmol. 2024;11206721241261418. doi: 10.1177/11206721241261418. Epub ahead of print. PMID: 38860310.
