Study compares iStent inject and 360° SLT in patients with early glaucoma

There is comparable safety and effectiveness between intraoperative iStent inject and postoperative 360° selective laser trabeculoplasty (SLT) in lowering intraocular pressure (IOP) and reducing the need for glaucoma medications in early glaucoma patients undergoing cataract surgery, according to a study.

In the retrospective non-randomized study, participants were divided into 2 groups: 1 group underwent cataract surgery with intraoperative iStent inject (n = 40), while the other underwent cataract surgery followed by postoperative SLT at 1 month (n = 33).

The primary endpoint of the study was achieving an IOP reduction of at least 20% from baseline to 6 months postoperatively.

Mean baseline IOP was 19.1 mmHg, with no significant difference observed between the groups. The iStent group had a higher mean baseline number of IOP-lowering medications (1.95) compared to the SLT group (1.53), a difference found to be statistically significant (P = 0.04).

At 6-months, 60% of patients in the SLT group and 51% in the iStent group achieved the targeted IOP reduction of ≥20%, with no significant discrepancy between the groups (P = 0.431). There was no discernible difference in the mean number of IOP-lowering medications between the 2 groups at 6 months (-0.92 for iStent, -0.89 for SLT). Similar trends were observed at the 12-month follow-up.

The authors concluded that the choice between these treatments should be guided by the ophthalmologist’s experience and a thorough evaluation of the cost-benefit ratio.

Reference
Martini K, Baillif S, Nahon-Esteve S, Denis P, Martel A. Intraoperative iStent versus postoperative selective laser trabeculoplasty in early glaucoma patients undergoing cataract surgery: A retrospective comparative study. J Fr Ophtalmol. 2023;S0181-5512(23)00412-6. doi: 10.1016/j.jfo.2023.03.042. Epub ahead of print. PMID: 37783587.