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. 2021 Sep 16;16(9):e0257015.
doi: 10.1371/journal.pone.0257015. eCollection 2021.

5-year outcomes of single iStent (G1) trabecular microbypass implantation with phacoemulsification in moderately advanced primary open angle glaucoma

Ejaz Ansari  1   2
Affiliations

5-year outcomes of single iStent (G1) trabecular microbypass implantation with phacoemulsification in moderately advanced primary open angle glaucoma

Ejaz Ansari. PLoS One. .

Abstract

Purpose: To evaluate the safety and efficacy of combined phacoemulsification and single iStent (G1) (iStent, Glaukos Corp. San Clemente, USA), implantation in moderately advanced primary open angle glaucoma (POAG) with 5-years follow-up.

Methods: Retrospective, interventional case series. All subjects had POAG and underwent single iStent implantation+ phaco+IOL by a single surgeon, with 5 years follow-up. Primary outcome measures: reduction in intraocular pressure (IOP) and proportion of eyes achieving at least 20% reduction of IOP at 5 years. Secondary outcome measures: number of glaucoma drops at 1 through to 5 years; change in visual field mean deviation (MD) at year 5 compared to baseline.

Results: 35 eyes of 26 patients were included. Mean (sd) medicated pre-op IOP was 18.5 (3.2) mm Hg on mean (sd) 2.3 (1.0) medications. Mean IOP was reduced to 15.9 (4.5) mm Hg on 2.2 (0.9) drops, 15.0mm (4.5) mm Hg on 2.3 (0.9) drops, 15.6 (3.6) mm Hg on 2.5 (1.0) drops, 15.7 (4.43) mmHg on 2.6 (1.0) drops and 14.7 (3.02) mmHg (P<0.001) on 2.7 (1.14) drops (P = 0.06) from 1 through to 5 years. At year 5, 62% of eyes had achieved at least 20% reduction in IOP. MD reduced from -8 (8.1) dB to -10.7 (13.4) dB over 5 years (p = 0.8) at 0.54dB/ annum. One eye required filtering surgery. There were no sight-threatening complications.

Conclusion: This study showed sustained IOP reduction and excellent safety profile for single iStent implantation. Uniquely it provides data for a more severe stage of glaucoma, and also visual field data, which indicated no significant change through 5 years.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Mean IOP through 5 years post-operative.
All eyes at each time point.
Fig 2
Fig 2. Percent of eyes with 20% or greater IOP reduction vs. preoperative.
All eyes at each time point through 5 years.
Fig 3
Fig 3. Kaplan-Meier analysis.
Time to filtration surgery. All eyes at each time point. Success 95.2% Kaplan-Meier survival curve.
See this image and copyright information in PMC

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