iStent in Dallas, Texas
iStent – Combining Cataract Surgery and Glaucoma Therapy Into a Single Procedure
Many of our Infinity Vision patients have some degree of glaucoma in addition to cataracts. Now, there is a new device that can be implanted during routine cataract surgery that can help with glaucoma. It’s called iStent and we offer implantation of this new device at Infinity Vision.
What is iStent?
iStent claims to be the “world’s tiniest medical device,” 20,000 times smaller than the intraocular lenses that are implanted to replace the clouded natural lenses in cataract surgery. The tiny iStent device improves the eye’s natural ability to direct fluid flow through the trabecular meshwork, which is the channel through which fluid normally drains from the eye. The problem is that in patients with mild-to-moderate open-angle glaucoma, the trabecular meshwork becomes clogged or blocked to some degree, limiting fluid drainage. This allows fluid levels to build in the eye, increasing intraocular pressure. This increased pressure impacts the optic nerve, degrading eyesight over time. This is glaucoma.
When Dr. Russell implants the iStent device during normal cataract surgery, it is placed through the trabecular network. This immediately opens the passage and allows fluid to drain more effectively.
How does the iStent device help with my glaucoma?
A blocked or clogged trabecular meshwork allows fluid levels to build in the eye, so the goal is to restore drainage. When we implant the iStent device it acts like a pipeline directly through the blocked meshwork. This allows the fluid to drain again, usually lowering pressure in the eye. For patients who have had to use glaucoma drops or other medications to reduce their intraocular pressure, having iStent in place may reduce or remove the need for that glaucoma medication.
Who is an ideal candidate for iStent?
The ideal candidate for iStent is a patient who has mild-to-moderate open-angle glaucoma and needs cataract surgery. Implantation of the iStent device is simply included as part of your routine cataract surgery. Of course, the ideal candidate needs to be healthy enough for cataract surgery to begin with.
What should I expect before an iStent procedure?
In most cases, you’ll continue to use your glaucoma eye drops to limit your intraocular pressure right up until your cataract surgery. There aren’t any specific changes to prepare for iStent prior to your normal cataract surgery.
How is the iStent procedure performed?
The cataract removal and iStent implantation procedure are usually performed under local anesthesia. Dr. Russell will first remove the cataract from your eye, and replace it with the artificial intraocular lens. Then he implants the iStent device into your trabecular meshwork. This takes only a few extra minutes.
What is recovery like after receiving iStent?
There isn’t any additional recovery from your iStent implantation. You’ll recover as you normally would for cataract surgery, which is not a difficult recovery. As with stand-alone cataract surgery, you’ll need to refrain from strenuous activities such as sports and any heavy lifting. You can’t increase pressure to your face and eyes.
Are there risks with iStent?
The FDA has approved iStent for treatment of open-angle glaucoma. The iStent implant is incredibly small, so it doesn’t interfere with MRIs and it won’t set off airport scanners. Its insertion is minimally invasive, and the risk of complications has been quite low. In some cases, there can be some bleeding in the eye, but that typically resolves within one week. In rare instances, the eye pressure can rise for a few days after the surgery, but this can be lowered with additional eye drops until this resolves.
What should I expect after receiving iStent?
The iStent device will create a permanent opening through the blockage of your trabecular meshwork, enabling your eye to naturally drain. By restoring this drainage, fluid levels within the eye should return to normal and this should lower pressure within the eye. In a clinical study with iStent, 68 percent of glaucoma patients who received iStent remained medication free at 12 months. Your results may vary, and Dr. Russell will determine if you are able to decrease or possibly stop using glaucoma drops moving forward.