Patients implanted with an iStent achieved significantly higher treatment success and were much less likely to need add-on medications five years post-operatively, compared to patients on topical prostaglandin, results of an international glaucoma study show.
The study, published in Ophthalmology Glaucoma, showed standalone implantation of two iStent trabecular micro-bypass stents in newly-diagnosed primary open-angle glaucoma (POAG) eyes achieved a 35.3% reduction in mean intraocular pressure (IOP) to 16.5 mmHg after five years of follow-up.
“The study adds meaningful outcomes data to the growing body of peer-reviewed evidence that implantation of a single or multiple iStents can reliably achieve sustained IOP reductions in an elegant, tissue-sparing procedure with a highly favourable safety profile,” the study’s authors said.
A total of 101 subjects were randomised in a 1:1 ratio to receive either two iStents in a standalone procedure or once-daily topical travoprost, a commonly prescribed prostaglandin. At five years, results showed:
- mean diurnal IOP dropped 35.3% for the iStent group vs 35.1% for the travoprost group, excluding eyes in both cohorts that underwent cataract surgery during follow-up
- treatment success – defined as mean diurnal IOP of 6 mmHg to 18 mmHg without add-on medication or secondary glaucoma surgery – was achieved in 77% of stent eyes vs 53% of travoprost eyes
- seventeen percent of stent eyes vs. 44% of travoprost eyes required add-on medication
- the need for add-on medication arose at a slower rate in the stent group than in the travoprost group, especially after two years of follow-up.
