Ideally, a device designed to provide a pathway for aqueous outflow for glaucoma patients would help make patients’ lives easier. A new study published in JAMA Ophthalmology is showing that the iStent (Glaukos) is doing so by reducing the need for daily eye drops, when compared with cataract surgery alone. The device is implanted in the trabecular meshwork of glaucoma patients during cataract surgery to bypass the clogged biological structure and, ultimately, reduce pressure.

The study looked at the medical records of 1,509 patients who underwent bilateral cataract surgery with iStent implantation and an additional 1,462 patients who underwent unilateral cataract surgery with iStent implantation.

The researchers found that, after 20 to 24 months, the proportion of patients receiving no drops increased postoperatively (to 64.7% from 41.2%). In the same time frame, patients who took at least one topical agent at baseline had a mean reduction of 1.01 medications with bilateral procedures and 0.61 for unilateral surgery. Of the 38 patients receiving oral carbonic anhydrase inhibitors preoperatively, none were still using them postoperatively. Sustained reduction in drops was even more likely in patients receiving three or more drops, the study’s authors wrote.

The study excluded patients who went on to receive laser trabeculoplasty or additional incisional glaucoma surgery.        

Wang S, Singh K, Stein J, et al. Ocular antihypertensive medication use after iStent implantation concurrent with cataract surgery vs cataract surgery alone in a large US health care claims database. JAMA Ophthalmology. September 27, 2018. Accessed October 3, 2018.