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Insights Cataract Refract Surg : Insights in Cataract and Refractive Surgery

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Review Article
Trabecular microbypass using iStent combined with cataract surgery
Yeoun Sook Chun
Insights Cataract Refract Surg 2025;10(2):42-51.   Published online June 30, 2025
DOI: https://doi.org/10.63375/icrs.25.007
AbstractAbstract PDFePub
Minimally invasive glaucoma surgery has revolutionized conventional glaucoma treatment due to its simple procedures, rapid recovery, and few complications. iStent, a trabecular microbypass that can be implanted via combined cataract surgery, has the advantage of lowering intraocular pressure (IOP) independent of bleb formation. Furthermore, it is straightforward to implement and does not involve a substantial burden. iStent has a synergetic effect with phacoemulsification. Combining iStent with phacoemulsification yielded a greater reduction of IOP and glaucoma eyedrops, as well as higher rates of visual field change, than when either modality was used in isolation. iStent has emerged as a new treatment option for patients with mild to moderate glaucoma. This review aims to improve readers’ understanding of iStent by summarizing the surgical techniques needed to correctly insert it for optimal outcomes and discussing problem-solving in the context of patient care.
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Original Article
Clinical manifestations after cataract surgery in patients with moderate Fuchs corneal endothelial dystrophy
Myung-Sun Song, Dong Hyun Kim
Insights Cataract Refract Surg 2025;10(1):19-25.   Published online February 28, 2025
DOI: https://doi.org/10.63375/icrs.25.006
AbstractAbstract PDFePub
Purpose
The aim of this study was to analyze the clinical outcomes of cataract surgery in patients with moderate Fuchs endothelial corneal dystrophy (FECD) in whom central endothelial cells could not be observed using specular microscopy.
Methods
This retrospective study included nine eyes in seven patients diagnosed with FECD who underwent phacoemulsification at a single institution between January 2023 and November 2024. A single experienced corneal specialist performed slit-lamp examination and phacoemulsification. Best-corrected visual acuity (BCVA), specular microscopy, and central corneal thickness (CCT) measurements were performed preoperatively and postoperatively, and the outcomes were compared.
Results
The mean age of the patients was 69.8±6.5 years. Three were male patients and four were female patients. The mean preoperative CCT was 559.5±51.8 μm and the mean peripheral endothelial cell density was 599.3±129.4 cells/mm2. BCVA significantly improved in all patients postoperatively, with a mean logMAR BCVA improving from 0.65±0.52 preoperatively to 0.19±0.14 postoperatively (P=0.002). The mean CCT showed no significant change (preoperative, 559.6±51.8 μm; postoperative, 566.8±45.1 μm; P=0.218). In patients with follow-up longer than 6 months, an increase in CCT was observed at 30 days postoperatively, but CCT returned to preoperative levels after 90 days.
Conclusion
In patients with moderate-to-severe FECD in whom central endothelial cells cannot be measured, phacoemulsification may provide favorable visual outcomes if peripheral endothelial cells are observed and corneal edema is absent preoperatively.
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