In a study of the iStent inject (Glaukos), researchers led by Ali Salimi, MD, of McGill University in Montreal, Canada, set out to assess the 1-year outcomes related to the implantation of 2 of the second-generation trabecular microbypass stents combined with cataract surgery (CE-TMS), exclusively in eyes with normal-tension glaucoma (NTG). This multicenter, consecutive case series included eyes that underwent CE-TMS to reduce IOP or glaucoma medication use. The 12-month efficacy measures included change in average IOP and medication burden. Safety included change in BCVA, cup-to-disc ratio, visual field mean-deviation, and retinal nerve fiber layer thickness. Intraoperative or postoperative adverse events were noted.

A total of 62 eyes with mild-to-severe NTG and average preoperative IOP of 15.82±2.94 mmHg on 1.50±1.28 glaucoma medications were included. Postoperatively, IOP declined by 22% from 15.82±2.94 mmHg to 12.32±2.58 mmHg, all eyes had IOP less than 18 mmHg (vs 74% preoperatively), and half had IOP less than 12 mmHg (vs 15% preoperatively). Medication burden decreased by 70% from 1.50±1.28 to 0.45±0.86, and 73% of the eyes were medication-free (vs 23% preoperatively). Safety was favorable, with no evidence of sight-threatening adverse events. The researchers, who published their findings in the journal Ophthalmology and Therapy, concluded that implantation of iStent combined with cataract surgery is efficacious in reducing IOP and medication burden with a favorable safety profile in eyes with mild-to-severe NTG.