Combined iStent® Inject Trabecular Micro-Bypass and Phacoemulsification in Australian Patients with Open-Angle Glaucoma

Combined iStent® Inject Trabecular Micro-Bypass and Phacoemulsification in Australian Patients with Open-Angle Glaucoma

Alon M Salby,1 Simon E Skalicky1,2 1Department of Ophthalmology, Royal Melbourne Hospital, Melbourne, VIC, Australia; 2Glaucoma Unit, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, AustraliaCorrespondence: Alon M Salby Email amicahmd@gmail.comPurpose: This retrospective audit aimed to evaluat...

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Autores principales: Salby AM, Skalicky SE
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2020
Materias:
glaucoma
istent inject
micro-invasive glaucoma surgery
trabecular micro-bypass
phacoemulsification
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/990b70863d904d95b3430c4f5e87b4d2
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spelling oai:doaj.org-article:990b70863d904d95b3430c4f5e87b4d22021-12-02T05:12:04ZCombined iStent® Inject Trabecular Micro-Bypass and Phacoemulsification in Australian Patients with Open-Angle Glaucoma1177-5483https://doaj.org/article/990b70863d904d95b3430c4f5e87b4d22020-03-01T00:00:00Zhttps://www.dovepress.com/combined-istentreg-inject-trabecular-micro-bypass-and-phacoemulsificat-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Alon M Salby,1 Simon E Skalicky1,2 1Department of Ophthalmology, Royal Melbourne Hospital, Melbourne, VIC, Australia; 2Glaucoma Unit, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, AustraliaCorrespondence: Alon M Salby Email amicahmd@gmail.comPurpose: This retrospective audit aimed to evaluate the impact of combined iStent® Inject (iSI) and phacoemulsification on medication number in Australians with open-angle glaucoma. Secondary outcomes included intraocular pressure (IOP), best-corrected visual acuity, refraction and visual fields.Patients and Methods: Patients with glaucoma that received combined iSI and phacoemulsification by the same surgeon between 1 February 2016 and 1 February 2018 were audited for postoperative medication number, pressures after 1 day, 1 week, 4 weeks and 6, 12, 18 and 24 months, visual acuity, refraction and visual fields. These parameters were compared to baseline levels and with those from a separate cohort of patients without glaucoma that received standalone phacoemulsification.Results: Forty-one patients (63 eyes) received the combined procedure. Thirty-four patients (59 eyes) received standalone phacoemulsification. Four weeks after receiving combined iSI and phacoemulsification the mean medication number was significantly reduced by 1.3 (p < 0.001) for those on medication at baseline and by 0.5 (p = 0.002) overall. Mean IOP was significantly reduced from baseline after 6 months (– 16%; p = 0.012; n = 35) and 12 months (– 29%; p = 0.004; n = 16). Patients receiving standalone phacoemulsification had short-term reductions in IOP at 4 weeks (– 8%; p < 0.001; n = 57) and 6 months (– 16%; p < 0.001; n = 32). These patients without glaucoma had lower pressures overall compared to those with glaucoma that received the combined procedure (p = 0.019). There were no differences in final visual acuity or refractive outcomes between groups.Conclusion: This audit suggests that iSI and phacoemulsification are at least as effective in controlling IOP as medical therapy. It may have an important role in reducing the medication burden in Australians with cataract and glaucoma. This study is one of the first to confirm refractive stability in concomitant iSI and phacoemulsification.Keywords: glaucoma, iStent Inject, micro-invasive glaucoma surgery, trabecular micro-bypass, phacoemulsificationSalby AMSkalicky SEDove Medical Pressarticleglaucomaistent injectmicro-invasive glaucoma surgerytrabecular micro-bypassphacoemulsificationOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 985-993 (2020)
institution DOAJ
collection DOAJ
language EN
topic glaucoma
istent inject
micro-invasive glaucoma surgery
trabecular micro-bypass
phacoemulsification
Ophthalmology
RE1-994
spellingShingle glaucoma
istent inject
micro-invasive glaucoma surgery
trabecular micro-bypass
phacoemulsification
Ophthalmology
RE1-994
Salby AM
Skalicky SE
Combined iStent® Inject Trabecular Micro-Bypass and Phacoemulsification in Australian Patients with Open-Angle Glaucoma
description Alon M Salby,1 Simon E Skalicky1,2 1Department of Ophthalmology, Royal Melbourne Hospital, Melbourne, VIC, Australia; 2Glaucoma Unit, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, AustraliaCorrespondence: Alon M Salby Email amicahmd@gmail.comPurpose: This retrospective audit aimed to evaluate the impact of combined iStent® Inject (iSI) and phacoemulsification on medication number in Australians with open-angle glaucoma. Secondary outcomes included intraocular pressure (IOP), best-corrected visual acuity, refraction and visual fields.Patients and Methods: Patients with glaucoma that received combined iSI and phacoemulsification by the same surgeon between 1 February 2016 and 1 February 2018 were audited for postoperative medication number, pressures after 1 day, 1 week, 4 weeks and 6, 12, 18 and 24 months, visual acuity, refraction and visual fields. These parameters were compared to baseline levels and with those from a separate cohort of patients without glaucoma that received standalone phacoemulsification.Results: Forty-one patients (63 eyes) received the combined procedure. Thirty-four patients (59 eyes) received standalone phacoemulsification. Four weeks after receiving combined iSI and phacoemulsification the mean medication number was significantly reduced by 1.3 (p < 0.001) for those on medication at baseline and by 0.5 (p = 0.002) overall. Mean IOP was significantly reduced from baseline after 6 months (– 16%; p = 0.012; n = 35) and 12 months (– 29%; p = 0.004; n = 16). Patients receiving standalone phacoemulsification had short-term reductions in IOP at 4 weeks (– 8%; p < 0.001; n = 57) and 6 months (– 16%; p < 0.001; n = 32). These patients without glaucoma had lower pressures overall compared to those with glaucoma that received the combined procedure (p = 0.019). There were no differences in final visual acuity or refractive outcomes between groups.Conclusion: This audit suggests that iSI and phacoemulsification are at least as effective in controlling IOP as medical therapy. It may have an important role in reducing the medication burden in Australians with cataract and glaucoma. This study is one of the first to confirm refractive stability in concomitant iSI and phacoemulsification.Keywords: glaucoma, iStent Inject, micro-invasive glaucoma surgery, trabecular micro-bypass, phacoemulsification
format article
author Salby AM
Skalicky SE
author_facet Salby AM
Skalicky SE
author_sort Salby AM
title Combined iStent® Inject Trabecular Micro-Bypass and Phacoemulsification in Australian Patients with Open-Angle Glaucoma
title_short Combined iStent® Inject Trabecular Micro-Bypass and Phacoemulsification in Australian Patients with Open-Angle Glaucoma
title_full Combined iStent® Inject Trabecular Micro-Bypass and Phacoemulsification in Australian Patients with Open-Angle Glaucoma
title_fullStr Combined iStent® Inject Trabecular Micro-Bypass and Phacoemulsification in Australian Patients with Open-Angle Glaucoma
title_full_unstemmed Combined iStent® Inject Trabecular Micro-Bypass and Phacoemulsification in Australian Patients with Open-Angle Glaucoma
title_sort combined istent® inject trabecular micro-bypass and phacoemulsification in australian patients with open-angle glaucoma
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/990b70863d904d95b3430c4f5e87b4d2
work_keys_str_mv AT salbyam combinedistentreginjecttrabecularmicrobypassandphacoemulsificationinaustralianpatientswithopenangleglaucoma
AT skalickyse combinedistentreginjecttrabecularmicrobypassandphacoemulsificationinaustralianpatientswithopenangleglaucoma
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