Decade-long study shows iStent’s enduring efficacy in glaucoma treatment

A long-term study on the use of first-generation trabecular micro-bypass stents (iStent) alongside cataract surgery in patients with primary open-angle glaucoma (POAG) demonstrates promising results over a decade, according to a study presented at ASCRS 2024. The study shows sustained effectiveness in reducing intraocular pressure (IOP) and medication usage over a 10-year period, with favorable safety outcomes.

The study, conducted as a longitudinal, single-center, consecutive case series, focused on eyes with mild to severe primary open-angle glaucoma (POAG). A total of 51 eyes underwent implantation of 2 iStents alongside cataract surgery, with follow-up data available for up to a decade postoperatively.

Results revealed a surgical success rate of 83%. Although 9 eyes required secondary glaucoma surgery during the follow-up period, the majority of cases demonstrated significant improvements. Intraocular pressure decreased by 27.4%, with levels dropping from 19.0 ± 3.9 mmHg preoperatively to 13.8 ± 2.1 mmHg at the 10-year mark, a statistically significant reduction.

Medication use also saw a significant decrease during the initial 4 years post-surgery. However, it gradually increased thereafter, though not to preoperative levels. Safety outcomes remained favorable, with stable retinal nerve fiber layer thickness observed throughout the follow-up period. Visual acuity loss attributable to glaucoma progression was minimal, with only one eye experiencing a significant decline.

Notably, the study highlighted an instance where an iStent was inadvertently placed in the suprachoroidal space, resulting in no significant adverse effects.

Reference
Salimi A, et al. A Decade-Long Outcomes of Two First-Generation Trabecular Micro-Bypass Stents with Cataract Surgery in Primary Open-Angle Glaucoma. Presented at: ASCRS Annual Meeting 2024.