Surgical Outcomes and Risk Factors for Failure of Phacoemulsification Combined with First and Second Generation Trabecular Micro-Bypass Stents in Normal-Tension Glaucoma
Hiroki Tsutsui, Sakurako Shimokawa, Shotaro Shimokawa, Masatoshi Fukushima, Shunji Nakatake, Keijiro Ishikawa, Kohta Fujiwara, Koh-Hei Sonoda, Yusuke MurakamiAbstract
Purpose:
To report 1-year surgical outcomes of phaco-iStent and phaco-iStent inject W implantation in Japanese patients with normal-tension glaucoma (NTG) and to explore factors associated with surgical failure.
Methods:
This single-centre retrospective study included 51 eyes of 38 consecutive patients with NTG who underwent phaco-iStent (n = 18 eyes) or phaco-iStent inject W (n = 33 eyes) implantation, with approximately 1 year of follow-up. Main outcome measures were intraocular pressure (IOP) and number of glaucoma medications, compared between the two groups. Surgical success was assessed using a modified composite definition. Statistical analyses accounted for the inclusion of both eyes from some patients.
Results:
Preoperative mean IOP and glaucoma medications were 13.8 ± 2.9 mmHg and 2.0 ± 1.1 in the phaco-iStent group; and 15.0 ± 3.4 mmHg and 2.8 ± 1.1 in the phaco-iStent inject W group. At 12 months, the adjusted between-group difference was 0.99 mmHg for IOP (95% CI, –0.62 to 2.60;
Conclusion:
Both phaco-iStent and phaco-iStent inject W reduced glaucoma medication use in Japanese patients with NTG, whereas the reduction in IOP was modest. No significant difference between the two procedures was found in the adjusted 12-month analyses.