| Clinical Outcomes of Trabecular Micro-Bypass Stent in Patients with Moderate to Severe Open-Angle Glaucoma |
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Seungahn Yang1, Jiwoong Lee2, Seung Min Lee1,3, Ji Eun Lee1,3, Sangwoo Moon1,3 |
1Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
2Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
3Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea |
Correspondence:
Sangwoo Moon, Tel: +82-55-360-2131, Fax: +82-55-360-2161,
Email: anstkddn0421@hanmail.net
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Received: 8 February 2026 • Revised: 16 April 2026 • Accepted: 21 April 2026 |
| Abstract |
Purpose
To evaluate 1-year clinical outcomes and response markers after implantation of a trabecular micro-bypass stent (iStent inject® W) in patients with moderate-to-severe open-angle glaucoma (OAG).
Methods
This retrospective cohort study included 22 eyes of 22 patients with moderate-to-severe OAG who underwent standalone iStent inject® W implantation (n = 4) or combined phacoemulsification with iStent inject® W (n = 18). Qualified surgical success was defined as intraocular pressure (IOP) ≤15 mmHg with glaucoma medications and either ≥25% IOP reduction or final IOP ≤12 mmHg if baseline IOP was ≤15 mmHg. Kaplan–Meier analysis was used for cumulative probability of success; Cox proportional hazards regression analysis was used to identify response markers of surgical failure.
Results
Based on 19 eyes after censoring 3 eyes requiring additional surgery, IOP reduced from 22.09 ± 5.62 mmHg preoperatively to 12.37 ± 2.43 mmHg at 1 year (p < 0.001). Cumulative qualified success rates were 90.9% at 6 months and 72.7% at 12 months. No statistically significant changes were observed in the number of IOP-lowering medications. Higher postoperative IOP at 1 week and 1 month were independently associated with a higher surgical failure rate (1 week: hazard ratio [HR], 1.118; p = 0.007, 1 month: HR, 1.341; p = 0.031). Transient hyphema occurred in 7 eyes and resolved within 1 week; iStent iris plugging occurred in 2 eyes; and 3 eyes required subsequent trabeculectomy.
Conclusions
iStent inject® W appeared to provide meaningful IOP reduction and may serve as an intermediate option in patients with moderate-to-severe OAG. Early higher postoperative IOP may be an early response marker associated with surgical failure. |
| Key Words:
Trabecular micro-bypass stent; Moderate-to severe open-angle glaucoma; Minimally invasive glaucoma surgery |
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