iStent: New Surgical Treatment for Glaucoma

Enlarged iStent

If you have glaucoma and cataracts, there is a new surgical option to tackle both at the time of your cataract surgery called the iStent. This tiny device (1 mm by 0.3 mm) helps control your eye pressure by increasing the outflow of fluid from the front of the eye. The eye is like a small plumbing system: there is fluid constantly entering the eye from behind the pupil and leaving it through a sponge-like meshwork at the edges of the eye in front of the colored iris. By placing the iStent, we bypass this meshwork, allowing the fluid to leave more quickly and with the goal of decreasing eye pressure.

The iStent is part of a new type of glaucoma care called Micro-Invasive Glaucoma Surgery or MIGS. In the past glaucoma was mainly managed with eye drops, lasers or extensive surgery. This new option is less traumatic to the eye than traditional glaucoma surgery but does need to be done at the time of cataract surgery. Once the cataract procedure is completed and the lens implant in place, we then turn the patient’s head to one side and insert the iStent. You cannot see or feel the stent.

How do you know if the iStent is an option for you? We will discuss this in more detail at your next eye examination but generally your glaucoma must be mild or moderate. If you have severe glaucoma, for example taking multiple medications for this or have significant vision loss, then other surgical options will be discussed. If you have already had cataract surgery or your cataracts are not ready yet for surgery, you also would not be a candidate for the iStent at this time.

Regardless of the treatment for glaucoma, close follow-up is important to be sure this condition is well controlled. That generally means seeing you at least every 6 months: one visit with dilating drops and the other with the side vision test along with the scan of the back of the eye. We look forward to sharing this new innovation in glaucoma care with you in the near future.

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