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Comparative Study
. 2025 Jun 1;34(6):428-432.
doi: 10.1097/IJG.0000000000002564. Epub 2025 Mar 13.

Comparison Between Phacoemulsification-iStent Inject W and Phacoemulsification-Micropulse Transscleral Laser Therapy in Asian Eyes With Mild-Moderate Open Angle Glaucoma

Michel M Figueras  1   2 , Naoki Okada  1   3 , Chai K Tan  1   4 , Maria C Aquino  1 , Marcus C J Tan  1   5 , Katherine W Lun  1 , Dawn K A Lim  1 , Seng C Loon  1 , Paul T K Chew  1 , Victor T Chang Koh  1   5
Affiliations
Comparative Study

Comparison Between Phacoemulsification-iStent Inject W and Phacoemulsification-Micropulse Transscleral Laser Therapy in Asian Eyes With Mild-Moderate Open Angle Glaucoma

Michel M Figueras et al. J Glaucoma. .

Abstract

Prcis: In this retrospective cohort study, the 1-year cumulative probability of failure was comparable, achieving 52.20% in the phacoemulsification-iStent inject W (phaco/iStent) group and 47.80% in the phacoemulsification-micropulse transscleral laser therapy (phaco/MPTLT) group ( P =0.994).

Purpose: To compare the 1-year efficacy and safety of phacoemulsification combined with iStent Inject W (phaco/iStent) and phacoemulsification combined with micropulse transscleral laser therapy (phaco/MPTLT).

Methods: A retrospective cohort study that included patients with mild-moderate open angle glaucoma (OAG) and cataract who underwent either phaco/iStent or phaco/MPTLT in a tertiary hospital in Singapore between August 1, 2016 and December 31, 2022. The primary outcome measures were cumulative probabilities of failure between the 2 groups, with failure defined as disease progression by ocular coherence tomography (OCT-RNFL) or visual field test (VFT), repeat glaucoma surgery, and inability to maintain intraocular pressure (IOP) lower than preoperative baseline or the use of glaucoma medications for 2 consecutive visits after 1 month postoperatively. In addition, postoperative mean IOP, average number of IOP lowering medications, visual acuity, and complications were analyzed.

Results: Forty-six patients were included. Twenty-three eyes underwent phaco/iStent and 23 had phaco/MPTLT. The 2 groups had comparable cumulative probabilities of failure (52.20% phaco/iStent, 47.80% phaco/MPTLT; P =0.994) and mean IOP (15.57±2.95 mm Hg phaco /iStent, 14.39±2.25 mm Hg phaco/MPTLT; P =0.136) after 1 year. The change in IOP before surgery to 12 months is -1.04±3.07 mm Hg in the phaco/iStent group ( P =0.593) and -2.43±4.12 mm Hg in the phaco/MPTLT group ( P =0.022). Both achieved significant medication reduction burdens ( P <0.05). Intraoperative and postoperative complication rates were similar.

Conclusion: Both groups showed comparable surgical efficacy and safety after 1 year. The phaco/MPTLT group demonstrated sustained IOP reduction 1 year postoperatively.

Keywords: glaucoma; micropulse transscleral laser therapy; minimally invasive glaucoma surgery.

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Conflict of interest statement

Disclosure: P.T.K.C. and M.C.A. are co-inventors of micropulse transscleral laser therapy (IRIDEX CORP, Mountain View, CA) and hold related patents. The remaining authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
The X-axis indicates time in months while the Y-axis indicates failure probability (%). The blue color represents the phaco/iStent group, while the green color represents the phaco/MPTLT group.
See this image and copyright information in PMC

References

    1. Abraham AG, Condon NG, West Gower E. The new epidemiology of cataract. Ophthalmol Clin North Am. 2006;19:415–425. - PubMed
    1. Ahmed I. A Brief History of MIGS. Aug 15, 2017. The Ophthalmologist .
    1. Samuelson TW, Sarkisian SR, Jr, Lubeck DM, et al. . Prospective randomized, controlled pivotal trial of an ab interno implanted trabecular micro-bypass in primary open-angle glaucoma and cataract: two-year results. Ophthalmology. 2019;126:811–821. - PubMed
    1. Le K, Saheb H. iStent trabecular micro-bypass stent for open-angle glaucoma. Clin Ophthalmol. 2014;8:1397–1945. - PMC - PubMed
    1. Tekeli O, Köse HC. Outcomes of micropulse transscleral cyclophotocoagulation in primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma. Eur J Ophthalmol. 2021;31:1113–1121. - PubMed

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