Why carry out this study?

Numerous studies have established the safety and effectiveness of iStent inject trabecular micro-bypass implantation in combination with cataract surgery in eyes with different types of glaucoma. However, their outcomes remain understudied in normal-tension glaucoma (NTG).

The present study aims to assess the 1-year outcomes of iStent inject implantation with cataract surgery exclusively in eyes with NTG.

What was learned from the study?

Intraocular pressure (IOP) at 12 months was significantly lower than preoperative IOP (12.3 ± 2.6 mmHg versus 15.8 ± 2.9 mmHg, respectively; p < 0.001). At 12 months, all eyes achieved IOP ≤ 18 mmHg (versus 74% preoperatively), 92% of eyes achieved IOP ≤ 15 mmHg (versus 45% preoperatively), and half (50%) of the eyes achieved IOP ≤ 12 mmHg (versus 15% preoperatively).

Medication burden at 12 months was significantly reduced from preoperative (0.45 ± 0.86 medications versus 1.50 ± 1.28 medications, respectively; p < 0.001). All eyes either maintained or decreased topical medications from baseline, with 66% of eyes eliminating ≥ 1 medication and 29% of eyes eliminating ≥ 2 medications from their preoperative regimen.

Implantation of two second-generation trabecular micro-bypasses combined with cataract surgery is efficacious in reducing IOP and medication burden with a favorable safety profile in eyes with mild-to-severe NTG.