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.
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 The applicator is then withdrawn.
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.