title: Combined iStent trabecular micro-bypass stent implantation and phacoemulsification for coexistent open-angle glaucoma and cataract: a long-term study.
abstract: OBJECTIVE
  To evaluate the long-term efficacy and safety of combined cataract surgery and Glaukos iStent implantation for coexistent open-angle glaucoma and cataract.
  
  
  METHODS
  Prospective, non-comparative, uncontrolled, non-randomised, interventional case series study. Subjects older than 18 years with coexistent uncontrolled mild or moderate open-angle glaucoma (including pseudoexfoliative and pigmentary) and cataract underwent phacoemulsification and intraocular lens implantation along with ab-interno gonioscopically guided implantation of one Glaukos iStent. The variables recorded during a minimum of 3 years of follow-up were: intraocular pressure (IOP), number of antiglaucoma medications and best-corrected visual acuity.
  
  
  RESULTS
  The 19 patients enrolled were 58-88 years old (mean age 74.6±8.44 years). Mean follow-up was 53.68±9.26 months. Mean IOP was reduced from 19.42±1.89 mm Hg to 16.26±4.23 mm Hg (p=0.002) at the end of follow up, indicating a 16.33% decrease in IOP. The mean number of pressure-lowering medications used by the patients fell from 1.32±0.48 to 0.84±0.89 (p=0.046). In 42% of patients, no antiglaucoma medications were used at the end of follow-up. Mean best-corrected visual acuity significantly improved from 0.29±0.13 to 0.62±0.3 (p<0.001). No complications of surgery were observed.
  
  
  CONCLUSIONS
  Combined cataract surgery and Glaukos iStent implantation seems to be an effective and safe procedure to treat coexistent open-angle glaucoma and cataract.
authors.affiliation: Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Arriola-Villalobos
authors.forename: José Maria
authors.initials: JM
authors.lastname: Martínez-de-la-Casa
authors.forename: David
authors.initials: D
authors.lastname: Díaz-Valle
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernández-Pérez
authors.forename: Julián
authors.initials: J
authors.lastname: García-Sánchez
authors.forename: Julián
authors.initials: J
authors.lastname: García-Feijoó
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002386:Cataract / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D018918:Phacoemulsification; D011446:Prospective Studies; D019919:Prosthesis Implantation; D015607:Stents; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests
chemical_list: D000959:Antihypertensive Agents