Beyond intraocular pressure: introducing a novel glaucoma-specific PROM for evaluating outcomes after IStent inject implantation combined with phacoemulsification cataract surgery.

UNLABELLED: This study aimed to develop and validate a glaucoma-specific patient-reported-outcome-measure (PROM) questionary to assess disease-specific burden across all severities of open-angle glaucoma (OAG), including patients undergoing combined IStent inject micro-bypass and cataract surgery.

METHODS

A cross-sectional, survey-based study was conducted among adults diagnosed with glaucoma, including members of the AGAF (Asociación-Glaucoma para Afectados y Familiares) and patients from two tertiary hospitals who had undergone combined trabecular micro-bypass (TMB) and phacoemulsification surgery. Patients were stratified into mild, moderate, or severe glaucoma groups based on responses to a glaucoma-specific PROM questionnaire. The primary objective was to assess patient perspectives on visual function, quality of life, and treatment satisfaction.

RESULTS

A total of 240 participants were included (57.5% female; 58.8% diagnosed > 10 years ago). Most patients (61.7%) had moderate glaucoma. Advanced disease was significantly associated with worse self-perceived visual ability, lower quality of life, increased physical and emotional burden, and decreased satisfaction with treatment (all p < 0.0001). Awareness of glaucoma prior to diagnosis was generally low, but post-diagnosis treatment knowledge was higher among those with milder disease. Functional dependence and socioeconomic impact increased with disease severity. Among TMB-treated patients (n = 35), 97% reported no adverse events or discomfort, and 94.3% expressed confidence in their prognosis. Quality of life and satisfaction post-surgery were high across severity levels.

CONCLUSIONS

Disease severity and delayed diagnosis negatively affect patients' experiences and outcomes. Early detection and intervention are critical. Combined cataract and TMB surgery with IStent Inject was associated with high satisfaction and minimal adverse effects within this patient-reported framework.