Clinical outcomes of combined cataract surgery with iStent inject® W implantation versus cataract surgery alone in patients with open-angle glaucoma: real life data in a community-based outpatient setting

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Abstract Purpose This study aims to evaluate and compare intraocular pressure (IOP) change and topical IOP-lowering medication use after combined cataract surgery with iStent inject ® W implantation versus cataract surgery alone in patients with open-angle glaucoma. Methods Retrospective comparative chart review of 150 patients (150 eyes) with different types of open-angle glaucoma, who were naïve to any previous ocular procedure and underwent combined cataract surgery with iStent ® W implantation (100 eyes) or cataract surgery alone (50 eyes). Study outcomes were median IOP change and the mean number of topical IOP-lowering medications at 3, 6 and 12 months after surgery. Results The median IOP change in the iStent inject ® W group at 3-, 6- and 12 months follow-up was − 4 (-6 to -2) mmHg ( p < 0.001), -4 (-6 to -1) mmHg ( p < 0.001), and − 4 (-6.75 to -2) mmHg ( p < 0.001), respectively. The median IOP change in the control group at 3-, 6- and 12 months follow-up was 0 (-1.25 to 2) mmHg, 1 (-1 to 3) mmHg, and 0 (-2.5 to 3) mmHg, respectively. IOP reduction in the study group was statistically significantly larger than in the control group at all follow-ups ( p < 0.001). We found a statistically significant difference between the mean number of topical IOP-lowering medications before and at 12 months in the combined surgery group ( p < 0.001) as compared to the control group. Conclusions This study shows a statistically significant IOP reduction at 3-, 6- and 12 months and reduction of topical IOP-lowering medications at 12 months after combined cataract surgery with iStent inject ® W implantation.

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