Minimally Invasive Glaucoma Surgery (MIGS) with iStent inject W in Primary Open-Angle Glaucoma (POAG): Clinical outcomes and best practices

Title : Minimally Invasive Glaucoma Surgery (MIGS) with iStent inject W in Primary Open-Angle Glaucoma (POAG): Clinical outcomes and best practices

Abstract:

Object: Primary open-angle glaucoma (POAG) remains a leading cause of irreversible blindness, with minimally invasive glaucoma surgery (MIGS) emerging as a pivotal strategy for early-stage management. This study aims to evaluate the clinical outcomes and safety of iStent Inject W implantation in Chinese POAG patients during the early postoperative period (6-month follow-up), alongside surgical technique optimization..

Methods: A prospective, single-center study enrolled 26 Chinese patients (26 eyes) with early-to-moderate POAG who underwent iStent Inject5W implantation alone or in conjunction with phacoemulsification. Primary outcomes included intraocular pressure (IOP) reduction, medication burden, and complication rates.

Results: A significant mean IOP decrease from 24.7±3.6 mmHg preoperatively to 15.2±2.8 mmHg at 12 months (p<0.001), with 78.4% of eyes achieving IOP ≤21 mmHg without additional medications. The mean number of glaucoma medications reduced from 2.1±0.9 to 0.8±0.5 (p<0.001). Complications were minimal, including transient mild hyphema (5.9%) and IOP spikes requiring short-term medical management (2.9%), with no cases of device migration or vision-threatening events.

Conclusion: iStent Inject W implantation in Chinese POAG patients achieves sustained IOP lowering and medication reduction within 12 months, with low complication rates. These findings validate its utility as a safe and effective minimally invasive approach for early disease management in the Chinese population.

Key Works: iStent Inject W, POAG, clinical outcome, Chinese

Biography:

Dr. Peng LU, Ph.D., M.D., is a Professor and Chief Ophthalmologist, Vice Director of Ophthalmology at The Second Hospital of Lanzhou University. With 34 years' experience, he specializes in glaucoma, cataracts, high-altitude ophthalmopathy, and laser treatments. A visiting scholar at Stanford, Oklahoma State, and Singapore's National University Hospital, he pioneered 360° trabeculectomy with iTrack for congenital glaucoma and introduced ABiC in China. Expert in canaloplasty and combined glaucoma-cataract surgeries, he serves on national committees and has published 70+ peer-reviewed papers.