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Combined cataract surgery with iStent inject reduces medication burden in glaucoma

Key Takeaways

  • Combined cataract surgery with iStent inject significantly reduced medication burden in patients with glaucoma.
  • However, there was no difference in intraocular pressure between the two groups after two years. 

High pressure in the eye (intraocular pressure, or IOP) can lead to glaucoma, and reducing IOP is the primary treatment for glaucoma. The iStent inject (Glauckos), a tiny device that can be implanted into the eye during cataract surgery, was designed to increase fluid outflow from the eye, thereby reducing IOP.  

Jennifer C. Fan Gaskin, MD, FRANZCO, a research fellow at the Centre for Eye Research Australia, and colleagues, conducted a study “to assess the efficacy [of the iStent inject] for lowering IOP, reducing glaucoma medication, and improving quality of life outcomes at 2 years following the implantation” of the device in 101 eyes from 87 patients with mild to moderate open angle glaucoma and cataracts. The researchers randomly assigned patients’ eyes 1:1 to combined cataract surgery with iStent inject (treatment group, n = 56) or cataract surgery alone (control group, n = 48), and followed up with them for 2 years.

At baseline, patients in the treatment and control groups showed similar mean medicated IOP and number of ocular hypotensive medications (eye drops to reduce IOP). “There was a significant difference demonstrated at 24 months of the primary effectiveness endpoint measure, with fewer glaucoma medications required on average in the iStent group compared to the control group, and a greater proportion of eyes that were medication-free at 24 months in the iStent group compared to the control group,” the researchers wrote in the journal Ophthalmology Glaucoma.

However, there was no clinically significant difference in IOP between the two groups after 24 months, suggesting that the iStent inject may not have a significant long-term or sustained effect on IOP control, John Assan, OD, FAAO, who was not involved in the study, noted in a commentary. Nonetheless, Assan concludes, “Clinicians may recommend the iStent inject to patients, as it facilitates aqueous humor outflow to reduce IOP, promising a better quality of life and treatment efficacy.”

Edited by Miriam Kaplan, PhD

Source: Cassandra Jenkins, Healio Optometry News, May 14, 2024; see source article