{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T04:52:03Z","timestamp":1777092723832,"version":"3.51.4"},"reference-count":9,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,4,8]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>This case reports the behaviour of a first-generation iStent implant in angle closure glaucoma. A primary angle closure glaucoma patient with a cataract and baseline intraocular pressure (IOP) of 31 mm Hg underwent phacoemulsification with an iStent implant. After an uneventful initial postoperative course, a sudden IOP spike was noted 5 days postoperatively.<\/jats:p>\n               <jats:p>Careful gonioscopy revealed an obstructed stent lumen due to peripheral iris incarceration. A simple non-invasive method of relieving the occlusion was tried, using pilocarpine 2% eye drops in the clinic, following which there was successful normalisation of IOP and relief of occlusion.<\/jats:p>\n               <jats:p>The propensity for stent occlusion is higher in primary angle closure disease and should be routinely monitored. A prophylactic use of pilocarpine in the early postoperative period can help reduce this risk. The patient remained medication-free till the last follow-up of 6 months with a significant IOP reduction of 48%.<\/jats:p>","DOI":"10.1136\/bcr-2024-259870","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T15:20:20Z","timestamp":1745335220000},"page":"e259870","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Generation 1 iStent occlusion in angle closure glaucoma as a reason for postoperative intraocular pressure spike treated using non-interventional methods"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9224-2936","authenticated-orcid":false,"given":"Sahebaan","family":"Sethi","sequence":"first","affiliation":[{"name":"Ophthalmology, Arunodaya Deseret Eye Hospital, Gurugram, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3191-8426","authenticated-orcid":false,"given":"Aditya","family":"Sethi","sequence":"additional","affiliation":[{"name":"Ophthalmology, Arunodaya Deseret Eye Hospital, Gurugram, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"2025082804394936000_18.4.e259870.1","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1097\/IJG.0000000000002195","article-title":"Intraocular Pressure Spikes Following iStent Inject and the Relationship to Aqueous Outflow in Open Angle Glaucoma","volume":"32","author":"Lusthaus","year":"2023","journal-title":"J Glaucoma"},{"key":"2025082804394936000_18.4.e259870.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2010.07.007"},{"key":"2025082804394936000_18.4.e259870.3","doi-asserted-by":"crossref","unstructured":"Shiroma LO , Costa VP . 56 - parasympathomimetics. In: Tarek MS , Mark BS , Hitchings RA , et al , eds. Glaucoma. 2nd edn. W.B. Saunders, 2015: 557\u201382.","DOI":"10.1016\/B978-0-7020-5193-7.00056-X"},{"key":"2025082804394936000_18.4.e259870.4","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3341\/kjo.2012.26.2.97","article-title":"Anterior chamber configuration changes after cataract surgery in eyes with glaucoma","volume":"26","author":"Kim","year":"2012","journal-title":"Korean J Ophthalmol"},{"key":"2025082804394936000_18.4.e259870.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-9071.2012.02805.x"},{"key":"2025082804394936000_18.4.e259870.6","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-019-00899-5"},{"key":"2025082804394936000_18.4.e259870.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2020.12.032"},{"key":"2025082804394936000_18.4.e259870.8","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/ceo.13721","article-title":"Phacoemulsification vs phacoemulsification with micro-bypass stent implantation in primary angle closure and primary angle closure glaucoma: A randomized single-masked clinical study","volume":"48","author":"Chen","year":"2020","journal-title":"Clin Exp Ophthalmol"},{"key":"2025082804394936000_18.4.e259870.9","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/S0161-6420(82)34866-6","article-title":"Side Effects and Ways to Avoid Them","volume":"89","author":"Zimmerman","year":"1982","journal-title":"Ophthalmology"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-259870","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:39:57Z","timestamp":1756381197000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-259870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":9,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,22]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bcr-2024-259870"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-259870","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}