I am studying the iStent inject^® in my practice, in conjunction with cataract surgery per its indication, in a predominantly Hispanic patient population. This is especially valuable given the paucity of available data regarding the safety and effectiveness of glaucoma surgical devices in this demographic group.

To date, my retrospective case series includes 56 eyes, 98% with primary open-angle glaucoma, in a predominantly Hispanic (66%) patient population. Thirty-nine patients have been followed for 6 months postoperatively. This real-world dataset shows substantial reduction in IOP and use of IOP-lowering medications (see Table 1).

Mean IOP at 6 months was 12.7 mmHg, down from 16.8 mmHg preoperatively, a 24.4% reduction. Medication use declined 89.5%, from an average of 1.71 medications to 0.18 medications. Also at 6 months, 89.7% of eyes were medication-free, and 87.2% of eyes had IOP ≤ 15 mmHg.

The safety of iStent inject in my patients, which I’m evaluating based on all relevant parameters, including adverse events and complications, visual acuity, visual fields, and retinal nerve fiber layer thickness, has been excellent.

Follow-up is ongoing, but early results show iStent inject to be effective in reducing IOP in patients with uncontrolled glaucoma going into cataract surgery, while also reducing medication burden. It’s also effective in maintaining IOP in those with controlled pressure and reducing or eliminating the need for medications altogether.

Investigator Insight: While several MIGS devices and treatments have become available to ophthalmologists in the past few years, manipulation of the conventional outflow system has proven to be an extremely safe, effective, and predictable option. iStent inject is one of my preferred strategies for managing patients with mild-to-moderate glaucoma undergoing cataract surgery to reduce IOP and/or medication burden, provided they have a healthy iridocorneal angle.

MARK GALLARDO, MD, practices at El Paso Eye Surgeons in Texas. He holds faculty positions at Texas Tech School of Medicine and The University of Texas Health Sciences Center, and is actively involved in research including multiple FDA clinical trials.