Ocular Surface Changes and Glaucoma: A Prospective Contralateral Study of IOP-Reducing Eyedrops versus iStent Inject Surgery

Purpose: To compare ocular surface outcomes between interventional glaucoma treatment with trabecular micro-bypass stent implantation and continued topical intraocular pressure-lowering therapy. Patients and Methods: A prospective, single-center, contralateral-eye study of patients with bilateral, mild-to-moderate open-angle glaucoma undergoing implantation of the iStent inject in the study eye, while the fellow eye (control eye) continued topical medications. Just over half the eyes in both groups underwent phacoemulsification. Ocular surface parameters were evaluated using objective tests and validated symptom questionnaires at baseline and at 1, 3, and 6 months. Results: Fifty-six eyes were included, 28 in each group. At 6 months, medication use reduced significantly in study eyes (from 1.9±1.0 preoperatively to 0.4±0.6; p