Outcomes Of Phacoemulsification Combined With Two Istent Inject Trabecular Microbypass Stents With Or Without Endocyclophotocoagulation

Aim Comparing outcomes after combined phacoemulsification, two iStents insertion and endocyclophotocoagulation (ECP) versus phacoemulsification-iStents alone.Methods This is a longitudinal retrospective 12 months study in eyes with ocular hypertension or early-to-moderate open angle glaucoma. Level of disease, intraocular pressure (IOP) and tolerance of glaucoma medication were considered before planning surgery. Best-corrected visual acuity (BCVA-logMAR), IOP (mm Hg), number of medications were assessed at baseline, week 1, week 5, month 3, 6, 12 postop. Main outcome: percentage (%) in IOP reduction at 12 months vs medicated baseline. Secondary outcomes: absolute values of IOP/medication reduction, BCVA and postop complications.Results The ICE2 (two iStents-cataract extraction-ECP) group included 63 eyes and Phaco-iStent group included 46 eyes. Baseline IOP was higher in the ICE2 than phaco-iStent group (19.97 +/- 4.31 mm Hg vs 17.63 +/- 3.86 mm Hg, p=0.004) and mean deviation was lower (-7.20 +/- 2.58 dB vs -4.94 +/- 4.51 dB, p=0.037). Number of medications were comparable at baseline: 2.22 +/- 1.06 (ICE2) vs 2.07 +/- 1.02 (phaco-iStent), p=0.442. At month 12 postop, IOP in the ICE2 group decreased 35% from baseline vs 21% in the phaco-iStent group (p=0.03); absolute IOP reduction was significantly lower than baseline in each group (p<0.001), yet final IOP was lower in the ICE2 group than phaco-iStent group (13.05 +/- 2.18 mm Hg vs 14.09 +/- 1.86 mm Hg, p=0.01). Similar results were found for glaucoma medication (1.24 +/- 1.05 in ICE2 group vs 1.39 +/- 1.03 in phaco-iStent group, p=0.01). Final BCVA was 0.11 +/- 0.18 (phaco-iStent group) vs 0.08 +/- 0.08 (ICE2 group), p=0.309. Safety outcomes were comparable between groups.Conclusion ICE2 procedure offers better results in IOP/ medication reduction at 12 months than phacoemulsification-iStents alone.