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PURPOSE: To evaluate the real-world efficacy and safety of iStent implanted standalone or combined with phacoemulsification in open-angle glaucoma (OAG) patients. METHODS: This is a retrospective observational study of OAG patients who underwent standalone or combined iStent procedures were reviewed. Inclusion criteria included age over 18 years and open angle on gonioscopy. Exclusion criteria were prior incisional glaucoma surgeries, missing data, or follow-up shorter than 6 months. The primary outcome was surgical success between the two groups after one year. Secondary outcomes included differences in IOP reduction and medication use. RESULTS: We included 48 eyes with primary (n = 44) and secondary OAG (n = 4). Nineteen eyes had standalone while 29 eyes had combined procedures. Kaplan-Meier analysis revealed overall surgical success in 31.3% of eyes after one year. Qualified success was higher in the combined group than the standalone group [62.5% (10 eyes) vs 27.3% (3 eyes), p = 0.239]. At 24 months, mean IOP reduced by 2.2 ± 2.5 mmHg vs 3.3 ± 2.9 mmHg, p = 0.333), and the number of medications reduced by 1.1 ± 1.2 vs 1.3 ± 0.1, p < 0.001) in the standalone and combined group, respectively. Stent occlusion occurred in two eyes. CONCLUSIONS: While both standalone and combined iStent procedures provide safe IOP reduction throughout 12 months, there was no statistically significant difference in surgical success between them.
RESUMO
Background and objective In corneal neovascularization, the peri-corneal vascular structure grows into a normally avascular cornea. This is due to an imbalance between the angiogenic and anti-angiogenic factors that sustain corneal transparency. There are various etiologies of this condition, and they can be divided into infective or non-infective causes, such as inflammation, trauma, or surgical causes. Corneal neovascularization has been shown to improve with the current treatments using steroids and anti-vascular endothelial growth factors. This study aimed to evaluate the effectiveness of topical bevacizumab as an anti-angiogenic agent in patients with corneal neovascularization. Methods This retrospective study included patients who suffered corneal neovascularization of various etiologies and completed six months of topical bevacizumab therapy between 2020 and 2022 at the Universiti Kebangsaan Malaysia Medical Centre. Results A total of 16 patients received treatment with topical bevacizumab over the three-year study period. Based on specified inclusion and exclusion criteria, 12 patients were eligible for inclusion in this study. Eight patients (66%) showed improvement in terms of either 'clock hours' of improvement, morphology, or regression of corneal neovascularization. All infective causes of corneal neovascularization showed improvement on completion of bevacizumab compared to other causes. Conclusion Topical bevacizumab can be one of the treatment choices for corneal neovascularization. As the outcome varies depending on the severity and chronicity of the condition, the attending ophthalmologist should treat each case differently. Although topical bevacizumab is more effective in mild and moderate cases, the indications for its use in chronic cases remain debatable as the results are unfavorable in such cases.