Opening hours: Monday to Friday: 8:30am - 5:30pm Saturday: 8:30am - 12:30pm Closed for Lunch: 1:00pm - 2:00pm
contact@leehmeyecentre.com.sg
Call us at 6470 3366

iStent for Glaucoma

iStent for Glaucoma

iStent inject trabecular micro-bypass stent for the treatment of mild-to-moderate open-angle glaucoma

What is the iStent inject?

The most common form of glaucoma is primary open-angle glaucoma, where the aqueous fluid that normally circulates in the front portion of the eye is blocked from flowing back out of the eye through a tiny drainage system. This causes the pressure inside your eye to increase, which can damage the optic nerve and lead to vision loss.

The iStent inject trabecular micro-bypass stent, one of the smallest known implants (0.36 mm long x 0.23 mm wide) used in humans, helps increase the outflow of fluid by creating an opening in the resistant drainage eye layer so that the fluid can flow through, thereby decreasing eye pressure. The iStent inject is the second-generation device of iStent, which was approved by the United States Food and Drug Administration in 2012.

Clinical trials* have shown that most patients with mild-to-moderate open-angle glaucoma implanted with iStent inject have decreased eye pressure and medication use compared with their previous treatment regimen for at least one year. Some patients managed to be on no medications.

LEE HUNG MING EYE CENTRE ISTENT GLAUCOMA TREATMENT

TheGlaukos CorporationiStent inject is preloaded with two stents. Each stent is approximately 0.3 mm in diameter and 0.4 mm long.

How are iStent inject stents implanted in the eye?

One iStent inject applicator implants two stents into one eye. The iStent inject can be implanted during a cataract surgery or as a standalone procedure. The benefit of doing it in the same setting as a cataract procedure is that the same tiny incision used to remove your cataract lens and implant a new lens can also be used to implant the stents. In a standalone procedure, the doctor will create the same single micro-incision as done in the common cataract procedure.

The doctor will tilt your head slightly. He will place a gonioscope onto your eye which is like a magnifying glass so that he can see the layers of the eye through the microscope. The iStent inject applicator which contains the stents will be inserted into the eye through the tiny incision, and the doctor will gently implant one stent into the resistant layer, move two-clock hours over and implant the other stent into the same layer. The applicator is then withdrawn.

Video animation depicting the iStent procedure

Who are good candidates for iStent Inject?

Patients with mild-to-moderate open-angle glaucoma who need to lower eye pressure, wish to reduce medication burden, find it difficult to comply with medical therapy or have side effects from medication may be suitable for iStent inject.


What are the risks and complications?

Clinical trials have shown iStent inject procedure and implant to be a safe and effective treatment option alternative for patients with mild-to-moderate open angle glaucoma. The few minor adverse events reported were treatable or resolved on their own.


References
*Arriola-Villalobos P, Martinez-de-la-Casa JM, Diaz-Valle D, et al. Glaukos iStent inject trabecular micro-bypass implantation associated with cataract surgery in patients with coexisting cataract and open-angle glaucoma or ocular hypertension: a long-term study. J Ophthalmol.2016;2016:1056573.
Fea AM, Belda JI, Rekas M, et al. Prospective unmasked randomized evaluation of the iStent inject versus two ocular hypotensive agents in patients with primary open-angle glaucoma. Clinical Ophthalmology. 2014;8:875-882.
Lindstrom R, Lewis R, Hornbeak DM, et al. Outcomes following implantation of two second-generation trabecular micro-bypass stents in patients with open-angle glaucoma on one medication: 18-month follow-up. Adv Ther. 2016;33:2082-2090.
Voskanyan L, Garcia-Feijoo J, Belda JI, et al. Prospective, unmasked evaluation of the iStent inject system for open-angle glaucoma: Synergy trial. Adv Ther. 2014;31:189-201.