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Aye Eye Doc – iStent for Glaucoma

by Rajesh Khanna, MD

Glaucoma is a disease that is caused by pressure build-up behind the eye. If not treated properly, it can lead to blurred vision or worse, blindness. Glaucoma affects more than 2.2 million people in the United States, and countless more around the world.

In June 2012, the US Food and Drug Administration approved the first device for glaucoma that can minimize or eradicate the need for eye drops. The device is called iStent Trabecular Micro-Bypass Stent System or simply, iStent.

1.   What is iStent for glaucoma?

iStent is a product of Glaukos Corporation and is the smallest device ever approved by the FDA. Used in combination with cataract surgery, it is designed to improve the flow of natural eye fluids to lower the pressure in the eye, thereby decreasing glaucoma.

2.   Who can benefit from iStent?

iStent is for adult patients suffering from cataract and mild or moderate open-angle glaucoma who are being treated with ocular hypotensive medication.

3.   How does iStent work?

iStent works by opening up the blockage to relieve the pressure in the eye. It is inserted through a minimally invasive 1.5-mm corneal incision during cataract surgery. According to clinical trials, 85% of iStent recipients experienced enough improvement that they were able to discontinue eye drops within one year.

4.   What are the benefits of iStent?

Aside from treating cataract and glaucoma, iStent has several other benefits:

  • The procedure is done as part of cataract surgery; it does not require additional postoperative care than the existing follow-up for cataract surgery. Patients can go home the same day.
  • iStent does not damage other important eye tissues, unlike other traditional surgeries. This means other treatment options in the future are still possible.
  • iStent helps save time, money, and effort when compared to using eye drops for glaucoma and cataract.

5.  What are the side effects of iStent?

The great thing about iStent having FDA approval is that the public has access to exact  data about the device. According to clinical trials, there are minimal possible adverse effects of iStent such as:

  • Post-operative corneal edema
  • Posterior capsular opacification
  • Stent obstruction
  • Post-operative corneal abrasion

6.   What other warnings or precautions do I need to know about iStent?

The makers of iStent make it clear that the device is contraindicated with:

  • Primary or secondary angle closure glaucoma
  • Neovascular glaucoma
  • Thyroid eye disease
  • Sturge-Weber Syndrome
  • Any disease that can cause heightened episcleral venous pressure. Additionally, iStent has not been established as useful for children, in patients with other prior eye trauma and other types of glaucoma (pseudoexfoliative, pigmentary, and uveitic). Use of more than one iStent is also not advised and the procedure should never be performed by anyone other than a duly licensed physician.

For more information or call  1(805) 230-2126

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