Two recent studies have reported data supporting the effectiveness of the iStent and iStent inject by Glaukos. In one of the first long-term studies of a MIGS device, data from a single private practice in South Dakota demonstrates 6-year effectiveness in both reducing IOP and medication burden from a single iStent implantation in conjunction with cataract removal. The study was published in the journal Clinical Ophthalmology. The case series included eyes implanted with a single trabecular microbypass stent in combination with phacoemulsification in patients with mild to severe POAG. Data were collected preoperatively and at day 1, week 1, month 1, and up to 6 years postoperatively. Primary outcome measures included mean IOP and number of glaucoma medications. Safety was noted by assessing the incidence of IOP spikes and need for additional surgery.
The study comprised 411 eyes. Mean IOP was reduced to 14.9±4.2 mmHg compared to 18.8±5.6 mmHg at baseline at 6 years postoperatively. The mean number of medications was reduced to 1.2±1.0 from 1.4±1.1 at baseline. In eyes with severe stage of disease, there was a mean IOP reduction >6 mmHg at 6 years postoperatively. Eyes with baseline IOP ≥18 mmHg achieved a more robust reduction in IOP. Fifteen eyes underwent a secondary glaucoma procedure. There were no intra- or postoperative complications.
The study concluded that trabecular microbypass stent implantation in combination with cataract surgery provides a sustained IOP reduction in eyes with mild-to-severe POAG. The degree of IOP reduction was more significant in eyes with higher baseline IOP and severe stage of disease.