Case report: Double implantation of the iStent inject in a high myope

The iStent inject is an ab-interno trabecular microbypass stent used in the treatment of primary open-angle glaucoma. Intraoperative complications are uncommon. However, we present the first reported case of simultaneous double-stent implantation, occurring in a 62-year-old Chinese male with high myopia and normal-tension glaucoma. Following an initial implantation failure, upon a single activation of the injector, simultaneous penetration of both stents into the trabecular meshwork occurred. Surgeons should be aware of the risk of double-implantation in myopic eyes with altered scleral rigidity, particularly when the first device is already located distally in the hub of the injector.