Prospective Interventional Cohort Study of Ocular Surface Disease Changes in Eyes After Trabecular Micro-Bypass Stent(s) Implantation (iStent or iStent inject ) with Phacoemulsification

摘要

IntroductionThis study sought to assess ocular surface disease changes following cataract surgery combined with trabecular micro-bypass stent(s) implantation (iStent or iStent inject ).MethodsThis prospective interventional single-arm clinical trial enrolled 47 eyes with mild-to-moderate open-angle glaucoma (OAG) on 1–4 glaucoma medications who underwent phacoemulsification and trabecular micro-bypass stent(s) implantation. Key glaucoma and ocular surface data through 3?months postoperatively included the Ocular Surface Disease Index score (OSDI), corneal/conjunctival staining (Oxford Schema), fluorescein tear break-up time (FTBUT), conjunctival hyperemia (Efron Scale), glaucoma medications, and intraocular pressure (IOP).ResultsMean OSDI scores improved from 40.1?±?21.6 (severe) preoperatively to 17.5?±?15.3 (mild) at 3?months ( p ?0.0001). While 73% of eyes had moderate or severe OSDI scores preoperatively, 29% had such scores at 3?months, and the OSDI score was normal in 57% of eyes versus 9% preoperatively. Mean FTBUT increased from 4.3?±?2.4?s preoperatively to 6.4?±?2.5?s at 3?months ( p ?0.0001); mean Oxford corneal/conjunctival staining reduced from 1.4?±?1.0 preoperatively to 0.4?±?0.6 at 3?months ( p ?0.0001); mean Efron conjunctival hyperemia score reduced from 1.4?±?0.7 preoperatively to 1.2?±?0.6 at 3?months ( p =?0.118). The number of glaucoma medications decreased from 1.5?±?0.9 to 0.6?±?0.8 mean medications (60% reduction, p ?0.0001), with all eyes maintaining or reducing medications versus preoperatively and 55% of eyes becoming medication-free (versus 0% preoperatively). Mean IOP reduced from 17.4?±?4.2?mmHg to 14.5?±?3.2?mmHg ( p ?0.0001). The safety profile was excellent.ConclusionImplantation of trabecular micro-bypass stent(s) (iStent or iStent inject ) with cataract surgery produced significant improvements in ocular surface health, alongside significant reductions in IOP and medications.