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

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). Setting King Fahad Hospital of the University, Al Khobar, Saudi Arabia. Design Prospective, non-comparative, uncontrolled, non-randomized interventional case series. Methods One iStent was implanted during phacoemulsification cataract surgery for adult patients with OAG by a single surgeon over a period of 3 years. Main outcome measures include number of anti-glaucoma medications, IOP, corrected distance visual acuity (CDVA) and complications. Results Thirty-six eyes of 33 patients with OAG underwent the surgery. The pre-operative mean IOP and mean anti-glaucoma medications were 17.47 ± 5.44 mmHg and 2.69 ± 0.92, respectively. At 1 year of follow-up mean, IOP decreased to 13.44 ± 1.99 (23.1% reduction) (P<0.001) and mean anti-glaucoma medications decreased to 1.47±1.13 (45.4% reduction) (P<0.001). Conclusion After 12-month follow-up, phacoemulsification with the implantation of a single iStent seems to be an effective and safe procedure to lower IOP and the number of anti-glaucoma medications, and to overcome the problems associated with medication nonadherence in OAG patients with cataracts.