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Combined iStent trabecular micro-bypass stent implantation and phacoemulsification for coexistent open-angle glaucoma and cataract: a long-term study
  1. Pedro Arriola-Villalobos1,
  2. José Maria Martínez-de-la-Casa2,
  3. David Díaz-Valle2,
  4. Cristina Fernández-Pérez3,
  5. Julián García-Sánchez2,4,5,
  6. Julián García-Feijoó2,4,5
  1. 1Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
  2. 2Servicio de Oftalmología, Hospital Clínico San Carlos, Departamento de Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
  3. 3Servicio de Medicina Preventiva y Salud Pública, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
  4. 4Instituto de Investigaciones Oftalmológicas Ramon Castroviejo, Universidad Complutense de Madrid. Madrid, Spain
  5. 5Cooperative Research Network on Age-Related Ocular Pathology, Visual and Life Quality, Instituto de Salud Carlos III, Madrid, Spain
  1. Correspondence to Dr Julian García-Feijoó, C/ San Francisco de Sales 23, Casa 2, Piso 10°B, 28040 Madrid, Spain; jgarciafeijoo{at}hotmail.com

Abstract

Aims To evaluate the long-term efficacy and safety of combined cataract surgery and Glaukos iStent implantation for coexistent open-angle glaucoma and cataract.

Methods Prospective, non-comparative, uncontrolled, non-randomised, interventional case series study. Subjects older than 18 years with coexistent uncontrolled mild or moderate open-angle glaucoma (including pseudoexfoliative and pigmentary) and cataract underwent phacoemulsification and intraocular lens implantation along with ab-interno gonioscopically guided implantation of one Glaukos iStent. The variables recorded during a minimum of 3 years of follow-up were: intraocular pressure (IOP), number of antiglaucoma medications and best-corrected visual acuity.

Results The 19 patients enrolled were 58–88 years old (mean age 74.6±8.44 years). Mean follow-up was 53.68±9.26 months. Mean IOP was reduced from 19.42±1.89 mm Hg to 16.26±4.23 mm Hg (p=0.002) at the end of follow up, indicating a 16.33% decrease in IOP. The mean number of pressure-lowering medications used by the patients fell from 1.32±0.48 to 0.84±0.89 (p=0.046). In 42% of patients, no antiglaucoma medications were used at the end of follow-up. Mean best-corrected visual acuity significantly improved from 0.29±0.13 to 0.62±0.3 (p<0.001). No complications of surgery were observed.

Conclusion Combined cataract surgery and Glaukos iStent implantation seems to be an effective and safe procedure to treat coexistent open-angle glaucoma and cataract.

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Footnotes

  • Competing interests The authors have no commercial or proprietary interest in any of the products or companies mentioned in this article. This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. JG-F is a consultant to Glaukos Corporation.

  • Ethics approval Ethics approval was provided by the Hospital Clinico San Carlos Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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