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12-Month Outcomes of Combined Phacoemulsification and iStent Inject in Asian Eyes with Normal Tension Glaucoma: A Single-Centre Experience

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Abstract

Purpose

To evaluate efficacy and safety of the iStent inject combined with phacoemulsification in Asian eyes with normal-tension glaucoma (NTG) up to 12 months after surgery.

Study design

Retrospective case series.

Methods

Retrospective case series of eyes undergoing surgery from April 2017 to August 2019. Outcome measures included intraocular pressure (IOP), number of topical glaucoma medications and adverse outcomes. Data were retrieved from the post-operative day 1 (POD1), week 1 (POW1), month 1 (POM1), month 3 (POM3), month 6 (POM6) and month 12 (POM12) timepoints. Data were analysed at each timepoint for eyes with available clinical data at that visit. Subgroup analysis was performed for a consistent cohort which included only eyes with data at all six follow-up timepoints.

Results

Data from 91 eyes in the collective subject group was analysed. Majority of subjects were male (53, 58.2%) and Chinese (79, 86.8%). Mean age was 73.2 ± 7.2 years. Pre-operatively, mean IOP was 14.3 ± 3.0 mmHg and mean number of medications was 1.5 ± 0.8. Significant IOP reduction was observed at all timepoints except POW1 and POM12. The number of medications was reduced at all timepoints (p < 0.001). By POM12, there was reduction of 1.2 ± 1.0 medications (p < 0.001). Both the collective and consistent cohorts demonstrated a trend towards decreasing surgical efficacy with time, in IOP reduction and decrease in medications. None of the eyes experienced sight-threatening complications.

Conclusions

Asian eyes with NTG undergoing combined phacoemulsification and iStent inject surgery demonstrated significant and sustained reduction in number of glaucoma medications up to 12 months post-operatively.

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Data availability

The material in this manuscript has not been previously published, and was previously presented at the World Ophthalmology Congress, June 2020 (Poster Presentation).

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Funding

Dr Bryan CH Ang and Dr Leonard WL Yip have previously received funding from Glaukos Corporation (travel, research, speaker’s honoraria). They have not received funding for his work in this publication. No other funding was received for the authors’ work in this study. The authors have no other relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore, Singapore

    Bryan C. H. Ang, Jeremy Y. W. Hu, John T. C. Kan & Leonard W. L. Yip

  2. Department of Ophthalmology, Woodlands Health Campus, National Healthcare Group Eye Institute, Singapore, Singapore

    Bryan C. H. Ang

  3. Department of Ophthalmology, Cardinal Santos Medical Center, Manila, Philippines

    Ivan C. R. O’Neill Tecson

Authors
  1. Bryan C. H. Ang
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  2. Ivan C. R. O’Neill Tecson
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  3. Jeremy Y. W. Hu
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  4. John T. C. Kan
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  5. Leonard W. L. Yip
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Contributions

Dr Bryan CH Ang and Dr Leonard WL Yip contributed to the study conception and design. Material preparation, data collection and analysis were performed by Dr Bryan CH Ang, Dr Ivan CR Tecson O’Neill, Dr Jeremy YW Hu and Dr John TC Kan. The first draft of the manuscript was written by Dr Bryan CH Ang, Dr Ivan CR Tecson O’Neill and Dr Jeremy YW Hu. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bryan C. H. Ang.

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Consent for Publication

All methods of data collection were followed in accordance with the Helsinki Declaration and approval from the Institutional Review Board of the National Healthcare Group, Singapore was obtained. All subject details were anonymised for the purpose of the study and waiver of patient consent had been granted by the Institutional Review Board in view of the retrospective nature of this study.

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Ang, B.C.H., Tecson, I.C.R.O., Hu, J.Y.W. et al. 12-Month Outcomes of Combined Phacoemulsification and iStent Inject in Asian Eyes with Normal Tension Glaucoma: A Single-Centre Experience. Int Ophthalmol 42, 611–620 (2022). https://doi.org/10.1007/s10792-021-02033-3

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  • DOI: https://doi.org/10.1007/s10792-021-02033-3

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