&lt;p&gt;Outcomes of Combined iStent Trabecular Micro-Bypass and Cataract Surgery for the Treatment of Open-Angle Glaucoma in a Saudi Population&lt;/p&gt;

Habash, Ahmed Al; Khan, Omar

doi:10.2147/opth.s249261

Cited by 14 publications

(17 citation statements)

References 31 publications

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“…A substantial number of studies have demonstrated significant long-term IOP reduction and medication reduction following the implantation of the iStent. [11][12][13][14][15][16] Our previous study 13 was focused on physiology of aqueous outflow and was intended to confirm the conclusions of work of Batista et al 17 Current manuscript is a typical clinic research, and similar to recent population studies [18][19][20] its aim is to confirm the results of iStent implantation combined with a cataract surgery taking into consideration a Caucasian Polish population.…”

Section: Introductionmentioning

confidence: 78%

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Treatment of Open-Angle Glaucoma with iStent Implantation Combined with Phacoemulsification in Polish Caucasian Population

Kozera

Konopińska

Mariak

et al. 2021

OPTH

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Purpose The aim of this investigation was to evaluate the impact of iStent (the first-generation trabecular bypass) implantation with phacoemulsification on the intraocular pressure (IOP) and glaucoma medication in subjects with mild to moderate open-angle glaucoma (OAG) and cataract in a Polish Caucasian population. Patients and Methods This prospective case series covered 78 eyes of (57 Polish Caucasian patients) that had undergone iStent implantation in conjunction with cataract surgery. Patients were surveyed preoperatively and at postoperative day 1, week 1, and months 1, 3, 6, 12, and 24. Pre- and postoperative outcome measurements included visual acuity, IOP, and medication burden. Intraoperative and postoperative complications were noted for the safety profile. For effective treatment, an IOP reduction ≥20% was assumed, regardless of the use of IOP-lowering drops. Complete surgical success was defined as an IOP ≤ 15 mmHg, medications free, and a qualified surgical success as IOP ≤ 15 mmHg with or without medications. Results Post-operatively at two years, mean IOP reduced from 18.5 mmHg to 16.1 mmHg. The mean medication burden dropped from 1.8 to 0.4 at the end of follow-up. Preoperatively, 2 (2.6%) eyes were medication free, but by postoperative month 24, 53 (68%) eyes were medication-free ( p < 0.05). Effective treatment was achieved in 50 cases (64%) at the end of follow-up period. Kaplan–Meier cumulative incidence of qualified success was 51.9% after 24 months, CI 95 [41.9%; 64.4%], while cumulative incidence of complete success after 2 years of observation was 35.1%, CI 95 [25.9%; 47.5%]. Conclusion The iStent device combined with a cataract surgery served to decrease, significantly and positively, both IOP and medication use in the 24-months follow-up in patients with coexistent OAG and cataract in Polish patients.

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Section: Introductionmentioning

confidence: 78%

“…Recently Al Habash and Khan 18 released interventional case series on 33 Arabic patients. The mean baseline IOP was 17.47 ± 5.44 mmHg and the mean number of IOP lowering medication was 2.69 ± 0.92.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Open-Angle Glaucoma with iStent Implantation Combined with Phacoemulsification in Polish Caucasian Population

Kozera

Konopińska

Mariak

et al. 2021

OPTH

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“…On the other hand, the most common complication of penetrating canaloplasty is a transient IOP elevation (37.8% > 25 mmHg and 26.7% > 30 mmHg) after the surgery, usually within the first month. This phenomenon frequently occurs in non-penetrating surgeries, like canaloplasty (3% > 30 mmHg to 30% > 25 mmHg) (Brusini, 2014;Grieshaber et al 2010;Matlach et al 2015;Grieshaber et al 2017a) and iStent implantation (10.1%-21%) (Arriola-Villalobos et al 2012;Voskanyan et al 2014;Al Habash et al 2020). Early transient IOP elevation may be due to residual viscoelastic agent, blood and exudative materials in Schlemm's canal during and after the surgery, while a relatively persistent elevated IOP may be related to the collapse of collecting channels secondary to long-term IOP elevation and inadequate aqueous outflow in PACG patients (Johnstone et al 1973;Allingham et al 1996).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of bleb‐independent penetrating canaloplasty in primary angle‐closure glaucoma: one‐year results

Zhang

Cheng

et al. 2021

Acta Ophthalmologica

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Purpose: To report the efficacy and safety of bleb-independent penetrating canaloplasty in the management of primary angle-closure glaucoma (PACG). Methods: This single-centre prospective interventional case series enrolled 57 eyes from 53 PACG patients with medically uncontrolled intraocular pressure (IOP) and peripheral anterior synechiae of over 270°. Penetrating canaloplasty, mainly consisted of tensioning suture-aided Schlemm's canal dilation and a trabeculectomy, was performed to create a direct communication between the anterior chamber and the Schlemm's canal. Postoperative IOP, number of glaucoma medications and procedure-related complications were evaluated. Rate of success was defined as IOP ≤ 21, ≤18 and ≤15 mmHg, and a ≥30% IOP reduction without (complete) or with/without (qualified) IOP-lowering medications. Results: A total of 45 eyes had 360°catheterization successfully completed. The mean preoperative IOP was 33.9 AE 11.7 mmHg (range, 13-59.6 mmHg), on 3.2 AE 0.8 glaucoma medications (range 2-5), which was decreased to 15.4 AE 3.7 mmHg (range, 8.6-22.5) and 0.2 AE 0.6 (range, 0-3) medications at 6 months and 14.8 AE 3.5 mmHg (range, 9-24) and 0.1 AE 0.3 (range, 0-1) medications at 12 months postoperatively. Complete success at 12 months were achieved in 78.9% (95% CI: 0.65-0.93), 71.1% (0.56-0.86) and 50.0% (0.33-0.67) eyes at IOP ≤ 21, ≤18 and ≤15 mmHg, respectively. Transient IOP elevation (>30 mmHg, 26.7%) and hyphema (11.1%) were the most common early surgical complications. Conclusion: Penetrating canaloplasty in PACG appeared to have good efficacy and safety profiles in this pilot study. Further studies are justified.

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“…The first-generation iStent trabecular micro-bypass stent (Glaukos, San Clemente, CA, USA) was designed to restore the natural physiological outflow of aqueous humor through the trabecular meshwork into the Schlemm’s canal. Due to its efficacy and good safety profile, this titanium microstent is increasingly being used during cataract phacoemulsification in patients with coexisting mild-to-moderate glaucoma [ 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Previous studies on the effect of iStent on the corneal endothelial status showed that one year after combined phacoemulsification-iStent surgery, the CECL ranged from 13.2% to 14.6% [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies on the effect of iStent on the corneal endothelial status showed that one year after combined phacoemulsification-iStent surgery, the CECL ranged from 13.2% to 14.6% [ 21 ]. The 2-year follow-up showed that the ECD reduction was comparable between eyes with glaucoma in which only phacoemulsification was performed and those in which combined phacoemulsification and iStent surgery were performed, being 12.3% and 13.1%, respectively [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Effect of the First Generation iStent on Corneal Endothelial Cell Loss—A Match Case-Control Study

Konopińska

Saeed

Lisowski

et al. 2021

JCM

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Glaucoma is the leading cause of irreversible blindness worldwide. The only proven factor in slowing the progression of glaucomatous neuropathy is lower intraocular pressure (IOP), which can be achieved with pharmacology, laser therapy, or surgery. However, these treatments are associated with various adverse effects, including corneal endothelial cell loss (CECL). In recent years, several novel surgeries for reducing the IOP, collectively referred to as minimally invasive glaucoma surgery (MIGS), have been developed, one of which is the iStent. However, the long-term effects of such surgeries remain unknown. We compared a group of patients with open-angle glaucoma and cataract who underwent phacoemulsification alone with a group of patients with similar demographic and clinical characteristics who underwent simultaneous phacoemulsification and iStent implantation. Overall, 26 eyes of 22 subjects who underwent a combined phacoemulsification-iStent procedure and 26 eyes of 24 subjects who underwent cataract surgery were included. Before surgery, endothelial cells accounted to 2228.65 ± 474.99 in iStent group and 2253.96 ± 404.76 in the control group (p = 0.836). After surgery, their number declined to 1389.77 ± 433.26 and 1475.31 ± 556.45, respectively (p = 0.509). There was no statistically significant difference in CECL between the two groups 18–24 months after surgery, despite increased manipulation in the anterior chamber and the presence of an implant in the trabecular meshwork in those with an iStent implant. Thus, iStent bypass implantation is a safe treatment in terms of CECL for mild-to-moderate open-angle glaucoma.

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<p>Outcomes of Combined iStent Trabecular Micro-Bypass and Cataract Surgery for the Treatment of Open-Angle Glaucoma in a Saudi Population</p>

Abstract: Purpose: To assess the effectiveness and safety of a single iStent trabecular micro-bypass stent implantation in combination with cataract surgery in lowering the intra ocular pressure (IOP) and number of anti-glaucoma medications in Saudi patients with open-angle glaucoma (OAG).

Cited by 14 publications

References 31 publications

Treatment of Open-Angle Glaucoma with iStent Implantation Combined with Phacoemulsification in Polish Caucasian Population

Treatment of Open-Angle Glaucoma with iStent Implantation Combined with Phacoemulsification in Polish Caucasian Population

Efficacy of bleb‐independent penetrating canaloplasty in primary angle‐closure glaucoma: one‐year results

Evaluation of the Effect of the First Generation iStent on Corneal Endothelial Cell Loss—A Match Case-Control Study

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