iStent – New Glaucoma Treatment for Cataract Surgery patients

So your doctor has told you that it’s time for cataract surgery. You are also being treated for glaucoma. There is now an exciting new technology that is available that may help either reduce your need for eye drops or improve your eye pressure on the eye drops your are currently taking. The Princeton Eye group is proud to be among the first in this area to offer this exciting new technology to its patients. It’s called the iStent Trabecular Micro-Bypass Stent. The iStent is the smallest implantable device in the human body, measuring 0.3 mm by 1.0 mm in size and it helps to allow fluid trapped inside the eye to get out more easily. The best part is, it can be done at the same time as your cataract surgery without causing any significant increase in the risk of your cataract surgery.

Glaucoma is one of the leading causes of irreversible blindness in the US today and it can come on gradually without any symptoms until the later stages of disease. It is often characterized by an increase in the pressure of the fluid inside your eye but some patients develop it even with normal eye pressure. In all cases, lowering the eye pressure can help to slow down or even stop this loss of vision from occurring. Current treatment modalities include drops, laser, or a more invasive form of glaucoma surgery known as a trabeculectomy. Trabeculectomy is a surgery for more advanced or severe cases of glaucoma where the drops are not working or the chance for severe vision loss is high. While effective in these patients, it is not appropriate for more mild cases cases of glaucoma due to its risk profile.

The iStent however, works to help allow fluid from inside the eye to drain out of the eye more efficiently, thus helping to lower the pressure. Imagine you had a drain in your shower and in order for the water to get our of the shower, it first needed to pass through a sponge. You can imagine that this would slow the outflow of water. If you took a straw however, and poked it through the sponge, the water would now have a direct path out of the shower and into the drain without having to pass through the sponge. This is exactly how the iStent works, allowing aqueous fluid (the water in the eye) to pass through the trabecular meshwork (the sponge) and out of the eye through Schlemms canal (the drain). The end result in US clinical trials were that 68% of patients at one year post-operatively were able to reduce their glaucoma medicines by one drop. With typical glaucoma copays of $50 or more per month, the savings could be hundreds of dollars per year not to mention the reduction in side effects and the worry of taking a drop everyday.

It is important to realize that not all patients will be able to reduce their drops but given it’s tremendous safety profile, it’s high efficacy rate and the fact that most medical insurances cover its insertion, it has become a highly desirable treatment for those who are about to undergo cataract surgery and who also have glaucoma.

To find out if this exciting device is appropriate for you or to schedule a consultation for cataract surgery in combination with the iStent, please call our office at 609-921-9437. Let our schedules know that you have a cataract and glaucoma and they can help you make a consultation with a surgeon in our group who does both vision saving procedures.