Clinical outcomes of combined cataract surgery with iStent inject® W implantation versus cataract surgery alone in patients with open-angle glaucoma: real life data in a community-based outpatient setting

This study aims to evaluate and compare intraocular pressure (IOP) change and topical IOP-lowering medication use after combined cataract surgery with iStent inject® W implantation versus cataract surgery alone in patients with open-angle glaucoma. Retrospective comparative chart review of 150 patients (150 eyes) with different types of open-angle glaucoma, who were naïve to any previous ocular procedure and underwent combined cataract surgery with iStent® W implantation (100 eyes) or cataract surgery alone (50 eyes). Study outcomes were median IOP change and the mean number of topical IOP-lowering medications at 3, 6 and 12 months after surgery. The median IOP change in the iStent inject® W group at 3-, 6- and 12 months follow-up was - 4 (-6 to -2) mmHg (p < 0.001), -4 (-6 to -1) mmHg (p < 0.001), and - 4 (-6.75 to -2) mmHg (p < 0.001), respectively. The median IOP change in the control group at 3-, 6- and 12 months follow-up was 0 (-1.25 to 2) mmHg, 1 (-1 to 3) mmHg, and 0 (-2.5 to 3) mmHg, respectively. IOP reduction in the study group was statistically significantly larger than in the control group at all follow-ups (p < 0.001). We found a statistically significant difference between the mean number of topical IOP-lowering medications before and at 12 months in the combined surgery group (p < 0.001) as compared to the control group. This study shows a statistically significant IOP reduction at 3-, 6- and 12 months and reduction of topical IOP-lowering medications at 12 months after combined cataract surgery with iStent inject® W implantation.