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Glaucoma

Comparative study highlights iStent superiority over ECP in glaucoma treatment

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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.

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