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Normal tension glaucoma (NTG) is a subset of open-angle glaucoma, demonstrating glaucomatous optic nerve damage in the absence of raised intraocular pressure (IOP). NTG is more prevalent in Asian populations. While generally slow-progressing, NTG may be associated with significant central visual field loss. In recent years, minimally invasive glaucoma surgery has been added to the armamentarium of glaucoma surgery. This prospective study aims to evaluate 12-month surgical outcomes of combined iStent inject (Glaukos Corporation, Laguna Hills, CA) implantation and phacoemulsification in Asian eyes with NTG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective, single-centre case series of 30 eyes followed up until 12\u00a0months after surgery. Outcome measures included IOP, number of glaucoma medications, best-corrected visual acuity (BCVA) and intra and postoperative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age of subjects was 73.1\u2009\u00b1\u20096.3\u00a0years. Majority were ethnic Chinese (n\u2009=\u200927, 90%). Baseline medicated mean IOP was 13.8\u2009\u00b1\u20092.4\u00a0mmHg and mean number of glaucoma medications was 1.3\u2009\u00b1\u20090.7. Mean Humphrey visual field mean deviation was\u2009\u2212\u200913.7\u2009\u00b1\u20097.6. The mean IOP reduction at all timepoints from postoperative month (POM) 3 onwards was statistically significant (all<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), with mean reduction of 1.2\u00a0mmHg (95% CI: 0.1\u20132.2,<jats:italic>P<\/jats:italic>\u2009=\u20090.037) by POM12. There was statistically significant reduction in mean number of medications from postoperative day (POD) 1 onwards (all<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), with mean decrease of 1.0 medication (95% CI: 0.9\u20131.1,<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) by POM12. By POM12, 25 (83.3%) eyes were medication-free. Three (10%) eyes had stent occlusion by iris requiring laser iridoplasty. One eye had gross hyphema which resolved on conservative management before POM1. Mean BCVA improved from the baseline 0.3\u2009\u00b1\u20090.3 logMAR\u00a0to\u00a00.1\u2009\u00b1\u20090.1 logMAR postoperatively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). There were no major adverse or sight-threatening events. No eyes required further glaucoma surgery during the 12-month follow-up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Asian eyes with NTG which underwent combined iStent inject implantation and phacoemulsification demonstrated a significant and sustained reduction in IOP and glaucoma medications, up to 12\u00a0months postoperatively.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s40662-022-00294-2","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T10:02:41Z","timestamp":1657101761000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma"],"prefix":"10.1186","volume":"9","author":[{"given":"Bryan Chin Hou","family":"Ang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenqi","family":"Chiew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivien Cherng Hui","family":"Yip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun Hau","family":"Chua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei Shan","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan O\u2019Neill C.","family":"Tecson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne Joyce","family":"Ogle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boon Ang","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen Kim","family":"Hee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elton Lik Yong","family":"Tay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vernon Khet Yau","family":"Yong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hon Tym","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard Wei Leon","family":"Yip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,5]]},"reference":[{"key":"294_CR1","unstructured":"Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, et al. 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Vivien Cherng Hui Yip has received research funding from Glaukos Corporation. Leonard Wei Leon Yip is a consultant for Glaukos Corporation and has received speaker\u2019s honorarium and research funding from Glaukos Corporation. The rest of the authors have no conflict of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"27"}}