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Cataracts & Glaucoma

iStent Glaucoma Surgery With Cataract Surgery

In the past, glaucoma and cataract surgery were two separate procedures. In 2012, the FDA approved a non-magnetic device called the iStent Trabecular Micro-Bypass Stent System to treat symptoms of glaucoma. This is the first device that has been approved in conjunction with cataract surgery. It reduces intraocular pressure (IOP) in adult patients with mild or moderate open-angle glaucoma and a cataract, who are currently on IOP medication.

The smallest device ever approved by the FDA (0.5mm x 1mm), iStent, is so tiny that you cannot see it or feel it—it’s about the size of a third of a grain of rice. iStent creates a permanent opening in your trabecular meshwork and helps improve the flow of fluid from your eyes to regulate IOP. Among many advantages, iStent:

  • Can reduce or eliminate use of glaucoma eye drops.
  • Protects eye tissue that often gets damaged by traditional surgeries.
  • Can be safely implanted during cataract surgery.
  • Has a rapid recovery time.
  • Allows for future treatment options for preserving vision.

The Surgery

The cataract removal and iStent procedures are usually performed under local anesthesia. Our surgeons will first perform the phacoemulsification procedure to remove the cataract . With an ultrasonic device, the cloudy lens is broken up and removed and an artificial intraocular lens (IOL) is inserted. Using the same incision, the titanium iStent will be inserted by a preloaded, single-use, sterile applicator. Then he will slowly advance the iStent into the trabecular meshwork of your eye and push the button on the inserter to release the iStent. The cataract removal and iStent implant only take about 15 to 20 minutes per eye.

Recovery time is quite quick, but our surgeons may recommend that you take an entire week off from work. You should refrain from strenuous activities like sports, lifting heavy objects or straining as this will increase your eye pressure.

The Results

The iStent device has proven to lower IOP as much as 2.4 to 9 mm HG when combined with cataract surgery. After the procedure, many iStent patients have been able to reduce or discontinue glaucoma drops.