Evidence map›Paper›PMID 40691726›Full record

ArticleEye (London, England)2025

Cataract surgery with and without trabecular micro-bypass stent in primary angle-closure glaucoma: a multi-centre cohort study.

Sara Issa, Cristina Ginés-Gallego, Ben Griffin, Panagiotis Dervenis, Chrysostomos Dimitriou, Madalina Pavel, Obeda Kailani, Mo Abu-Bakra, Sameer Trikha, Avi Kulkarni and 2 more

Abstract readMulticenter StudyComparative Study
In one paragraph

Article in Eye (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Sara Issa *King's College Hospital NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0001-6725-3860
Cristina Ginés-Gallego *King's College Hospital NHS Foundation Trust, London, UK. christina.gallego@nhs.net.ORCID http://orcid.org/0000-0001-9256-8039
Ben GriffinKing's College Hospital NHS Foundation Trust, London, UK.
Panagiotis DervenisColchester Eye Centre of East Suffolk and North Essex NHS Foundation Trust, Colchester, UK.ORCID http://orcid.org/0000-0002-9303-2161
Chrysostomos DimitriouColchester Eye Centre of East Suffolk and North Essex NHS Foundation Trust, Colchester, UK.
Madalina PavelKing's College Hospital NHS Foundation Trust, London, UK.
Obeda KailaniKing's College Hospital NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0002-6623-1720
Mo Abu-BakraKing's College Hospital NHS Foundation Trust, London, UK.
Sameer TrikhaKing's College Hospital NHS Foundation Trust, London, UK.
Avi KulkarniKing's College Hospital NHS Foundation Trust, London, UK.
Stafford SansomeKing's College Hospital NHS Foundation Trust, London, UK.
Gerassimos LascaratosKing's College Hospital NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0001-5936-1431

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare the effectiveness and safety of phacoemulsification with iStents (phaco-iStent) vs. phacoemulsification alone (phaco-alone) in primary angle-closure glaucoma (PACG).

methodsRetrospective, cohort, multi-centre study. The primary outcome was surgical success during follow-up, defining complete success(CS) as intraocular pressure(IOP) 6-18 mmHg without reoperations and ≥20% IOP reduction without medications, and qualified success(QS) as IOP 6-18 mmHg without reoperations and either ≥1medication reduction or ≥20% IOP reduction on the same medications. Secondary outcome measures were IOP reduction, number of glaucoma medications (nmeds), visual acuity (VA) and complications. Factors for failure were explored using Cox regression. Continuous variables were expressed as mean ± standard deviation.

resultsOne hundred and eighty-five eyes included, 90 phaco-alone and 95 phaco-iStent (mean age 77.7 ± 9.0 years, mean follow-up 24.6 ± 9.2 months). Whereas no differences were found in IOP reduction between groups, nmeds reduction was higher in phaco-iStent at month 1 (p = 0.006), 6 (p = 0.002), 12 (p = 0.005) and 24 (p = 0.02). CS was achieved in 13.8% phaco-iStent and 10.1% phaco-alone (p = 0.46), while QS was achieved in 54.3% and 62.0%, respectively (p = 0.30), with no differences in the survival function distributions. Cystoid macular oedema and anterior uveitis were reported in six phaco-iStent. There were no long-term sight-threatening complications or differences in postoperative VA change between groups.

conclusionAdding iStent to phacoemulsification may provide a modest reduction in glaucoma medications with similar IOP control than phacoemulsification alone in selected PACG patients. While generally safe, the risks of postoperative macular oedema and uveitis should be weighed against the benefit of reducing medication. Prospective, cost-effectiveness studies of iStent in PACG are warranted.

Indexed as

Glaucoma, Angle-ClosureGlaucoma Drainage ImplantsPhacoemulsificationStentsTrabecular MeshworkAgedAged, 80 and overFemaleFollow-Up StudiesHumansIntraocular PressureLens Implantation, IntraocularMaleMiddle AgedRetrospective StudiesTreatment Outcome

Identifiers

PMID40691726
PMCPMC12446436

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.