Intraocular Pressure Fluctuation as Assessed by Water Drinking Test following iStent Inject Implantation in Open-Angle Glaucoma Patients

Introduction:This study investigated the intraocular pres-sure (IOP)fluctuation as assessed by the water drinking test(WDT) in open-angle glaucoma (OAG) patients after com-bined cataract surgery with iStent implantation.Methods:This was a prospective non-randomized comparative study.Eyes with OAG and cataracts that were planned for eithercombined phacoemulsification and iStent implantation(iStent+CS) or phacoemulsification alone (CS) were re-cruited. The iStent inject (Model G2-M-IS) or iStent injectW(Model G2-W) trabecular micro-bypass stent (GlaukosCorporation, San Clemente, CA, USA) was implanted in theiStent+CS group. WDT was performed before and 3 monthsafter surgery. WDT-IOP parameters including peak IOP, IOPfluctuation, and area under the curve (AUC) were comparedbetween the two groups.Results:Therewere20eyesintheiStent+CS group and 16 eyes in the CS group. Both groupshad similar pre-operative baseline IOP (15.6 +/- 3.7 mm Hg vs.15.8 +/- 1.8 mm Hg in the iStent+CS and CS group, re-spectively,p= 0.883). The iStent+CS group experiencedgreater numerical reduction in peak IOP (2.6 +/- 1.9 mm Hgvs. 1.9 +/- 2.4 mm Hg;p= 0.355), IOPfluctuation (1.7 +/- 2.2 mmHg vs. 0.8 +/- 2.5 mm Hg;p= 0.289), and AUC (54.8 +/- 103.6 mm Hg x minute vs. 25.3 +/- 79.0 mm Hg x minute;p=0.355) than the CS group. There was more reduction in thenumber of anti-glaucoma medications in the iStent+CSgroup (1.4 +/- 1.2) than the CS group (0.3 +/- 0.9;p=0.005).Conclusion:Both combined phacoemulsification with iS-tent inject implantation and phacoemulsification alonereduced peak IOP, IOPfluctuation, and AUC, and none ofthese parameters showed statistically significant difference.Greater reduction in anti-glaucoma medications was seen inthe combined group.(c) 2024 The Author(s).Published by S. Karger AG, Basel