Insights in Cataract and Refractive Surgery

Review Articles

Glaucoma evaluation and management in refractive surgery candidates: a review: Yeoun Sook Chun; Insights Cataract Refract Surg 2026;11(2):27-39. Published online June 18, 2026; DOI: https://doi.org/10.63375/icrs.26.002

Abstract PDF ePub: The global prevalence of refractive surgery for myopia has increased substantially; however, definitive guidance regarding its effects on glaucoma assessment and progression remains limited. Although advances in technology and diagnostic instruments have improved the detection and monitoring of glaucoma in patients undergoing refractive surgery, concerns persist regarding postoperative intraocular pressure (IOP) elevation and the inaccuracy of IOP measurements associated with reduced central corneal thickness. Myopia is a well-established risk factor for primary open-angle glaucoma, and this risk may be further increased by various intraoperative and postoperative factors related to refractive surgery. Therefore, thorough preoperative glaucoma screening, along with systematic postoperative follow-up and evaluation, is essential. This review delineates key considerations before refractive surgery and summarizes important clinical issues in eyes that have undergone refractive procedures. Furthermore, it outlines the pathogenesis, mechanisms, and management strategies for postoperative IOP elevation.

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

Abstract PDF ePub: 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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