iStent implantation with cataract surgery reduces glaucoma medication burden

Investigators assessed whether iStent implantation during cataract surgery was associated with a greater reduction in ocular antihypertensive medication usage compared with cataract surgery alone.

Study design

This retrospective analysis included 2,971 participants with primary open-angle glaucoma, narrow angles or secondary glaucoma who were enrolled in a U.S. managed care network. The study group underwent bilateral iStent implantation concurrently during cataract surgery. An equal number of matched individuals who underwent bilateral cataract surgery alone served as controls.

Outcomes

Compared with controls, patients who underwent iStent implantation with concurrent cataract surgery had a greater mean reduction in drop usage (0.99 vs 0.49) and a higher proportion of patients who were drop free (73.5% vs 55.3%) at 2 years postop.

Limitations

This was a large database study where unilateral drop usage cannot be determined. It is difficult to draw conclusions as not all surgeons likely attempted to remove drops after either type of surgeries. Being retrospective, there were no protocols.

Clinical significance

This study demonstrates that iStent placement potentially decreases medication dependence over cataract surgery alone.