Key Takeaways
- iStent use increased from 3.4% to 9.4% of glaucoma surgeries between 2010 and 2022.
- At 12 months, mean IOP and glaucoma medication use were both reduced across 145 treated eyes.
- Surgical success rates improved over time as the device was used earlier in the disease course.
The use of iStent in glaucoma surgery has become more integrated into routine glaucoma care over the past decade, according to a study that found its use has expanded in earlier-stage disease.
The retrospective longitudinal study included 145 eyes that underwent iStent implantation between 2010 and 2022. Researchers found that iStent procedures rose from 3.4% to 9.4% of all glaucoma surgeries during the study period. Combined cataract and iStent surgery was performed in 95.9% of cases.
At 12 months across the 145 treated eyes, mean IOP fell from 19.2 mmHg to 16.4 mmHg, while average glaucoma medication use declined from 1.9 to 0.6. Surgical success rates ranged from 49.6% to 81.0%, depending on whether success was defined as IOP below 21 mmHg with reduced medication use, IOP below 18 mmHg with reduced medication use, or IOP below 21 mmHg with at least a 20% reduction from baseline.
Between 2020 and 2022, success rates increased to 89.8%, 78.0%, and 57.6% across the 3 success criteria, respectively. During the same period, iStent procedures were increasingly performed in patients with lower baseline IOP and less advanced visual field loss.
Reference
Garcia-Bardera J, Morales-Fernández L, Pons-María M, et al. Is the interventional glaucoma paradigm reflected in real-world practice? Insights from iStent combined with cataract surgery (2010-2022). Eur J Ophthalmol. 2026;11206721261452042. doi: 10.1177/11206721261452042. Epub ahead of print. PMID: 42131899.
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