Effectiveness and safety of istent inject as an interventional glaucoma approach for uncontrolled open-angle glaucoma

Introduction: To describe the results of iStent inject implantation as a standalone procedure in early-stage uncontrolled glaucoma, with results up to 24 months. Methods: A retrospective, single-center case series that recruited patients with open-angle glaucoma (OAG), uncontrolled IOP (defined as >= 18 mmHg), and who are receiving 1-4 glaucoma medications were implanted the iStent inject as a standalone procedure. Exclusion criteria were the contraindications of iStent inject implantation. Primary outcome measures were IOP at 6, 12, 18, and 24 months compared to baseline, and the number of medications at baseline and 24 months. Results: Eighty-eight eyes from 88 patients, aged 57.6 +/- 9.8 years, were included. Ten eyes underwent a subsequent glaucoma procedure during follow-up and were excluded from the analysis. The mean IOP (mmHg) was reduced from 20.54 +/- 1.42 at baseline to 15.99 +/- 1.98 and 16.15 +/- 2.21 (n = 78, p < 0.001) at the 12- and 24-month follow-up, respectively, and the mean number of medications was reduced from 2.35 +/- 0.70 to 1.31 +/- 0.80 (p < 0.001) at 24 months. Of those eyes, 59% had >= 20% reduction in IOP at 24 months, 91% had an IOP <= 18 mmHg at 24 months, and 71.8% were receiving fewer medications. At 24 months, 14.1% of eyes were medication-free, compared to none at baseline. No serious intraoperative or postoperative adverse events occurred. Discussion: iStent inject can effectively control intraocular pressure in mild glaucoma, reducing medication reliance and improving patient quality of life.