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iStent implant for minimally invasive glaucoma surgery - A State of Sight #125

The iStent helps lower eye pressure by providing a pathway for fluid drainage inside the eye. This can help control mild to moderate glaucoma.

Watch this episode of A State of Sight with Isaac Porter, MD to learn more about this new technology that can be placed at the time of cataract surgery.


Welcome to A State of Sight, I’m Isaac Porter and this is your update in ophthalmology and eye care from Raleigh. Today, I would like to explain the iStent, which is a new implant for the management of glaucoma.


It is designed to be placed at the time of cataract surgery and it is one of the options available in a new category of procedures called minimally invasive glaucoma surgery. This goes by MIGS for short and these operations are an alternative to the traditional, more invasive, and more extensive procedures that are currently available for glaucoma patients.


The iStent is very small, in fact, it’s the smallest known implant that is placed in the entire human body. This is an example (in the video), you really can’t see it but there is an actual life size iStent right here in this disc. If you look online, you can see some other photos of it. It’s actually smaller than the “20” of the 2016 that is stamped on a penny.


This glaucoma drainage device provides an alternative exit pathway for fluid that is inside the eye. The natural drainage system in the front of the eye is called the trabecular meshwork. This is located right where the cornea and the iris meet in an area that is medically called the angle.


At the time of cataract surgery we can place this stent directly into this drainage system (trabecular meshwork) to give an alternate flow pathway with less resistance for the fluid exiting the eye. With this, many patients may be able to use less drops to control their glaucoma after surgery. If patients are only on one or two drops beforehand, they may be able to stop one or both of the drops and still have their pressure controlled adequately to keep their glaucoma under control.


Medical device companies are already working on newer versions of this stent and other similar types of stents and drainage devices. Later, we may be able to put in multiple implants, whereas now with the iStent in the United States, we can only place one at the time of cataract surgery. Other options in the future could be placing similar stents without having to do it at the time of cataract surgery.


If you have glaucoma, or if you are wondering about any other options that you may have to control your eye pressure, please post below and we will be happy to answer them. We hope to see you again soon next time on A State of Sight.