Purpose: To evaluate the effect of standalone iStent inject implantation on intraocular pressure and the medication burden in patients with pseudoexfoliative (PEX) glaucoma, and to compare these findings with results reported for open-angle glaucoma without subtype stratification.
Materials and Methods: A search was conducted in PubMed Central, the Cochrane Library, and the ClinicalTrials.gov registry using keywords; “iStent”, “standalone”, and “pseudoexfoliative”. A total of 182 articles were identified, of which only one study met the inclusion criteria (see PRISMA Flow 2020 diagram). For comparison, the only available meta-analysis from Healey et al. [4] was used. (keywords: “iStent”, “standalone”, “meta-analysis”)
Results: Due to the limited number of eligible studies, a scoping review approach was adopted. The vast majority of screened studies did not provide data for individual subtypes of open-angle glaucoma or include outcomes from combined cataract surgery. The single included study comprised 15 eyes of 15 patients with PEX glaucoma. The followup period was 6 months. Intraocular pressure was reduced from 23.75 ±3.28 mmHg to 15.33 ±1.07 mmHg, representing a 35% reduction (p < 0.001), and antiglaucoma medication was reduced from an average of 2.33 to 1.04 (p < 0.001).
Conclusion: This scoping review provides an initial overview of current research on the standalone use of MIGS iStent inject in patients with PEX glaucoma. A major limitation is the identification of only a single relevant study, which precludes a deeper synthesis and metaanalysis. Overall, the available evidence remains limited and represents only a preliminary step toward further research that may yield more comprehensive insights and stronger foundations for clinical decisionmaking.