Microinvasive Glaucoma Surgery

Microinvasive Glaucoma Surgery

High eye pressure.

High pressure inside the eye is the major risk factor for glaucoma progression. If your eye pressure is not maintained to within the accepted range for your eye, you run the risk of permanent loss of vision.

Treatment options for glaucoma.

While there is no cure for glaucoma, proper treatment to keep the eye pressure low and regular follow up will reduce the risk of vision loss. Treatment of glaucoma usually starts with eye drops. However, if eye drops fail to maintain the pressure in your eye to within the accepted level, or you are having problems with the use of eye drops then the next stage would be laser or surgery. Your doctor would advise you on the best option for you.   If you have cataract and glaucoma or you have had your cataract removed, then Microinvasive Glaucoma Surgery using the iStent is a good option.

What is iStent?

The iStent Trabecular Micro-Bypass stent is a new surgical treatment for glaucoma designed to improve the flow of fluid inside the eye and safely lowering eye pressure. It is the smallest medical device approved by the FDA for mild to moderate open-angle glaucoma. It is made out of surgical grade nonferromagnetic Titanium that is totally inert.

It will not be rejected by the body or cause allergic reaction. Also, it will not interfere if you ever need an MRI scan.

What are the advantages of iStent?

The device is so small you will not be able to see it or feel it after surgery. It will work continually in the background to bring the eye pressure low enough to maintain your glaucoma control. From studies the iStent can reduce the eye pressure by 20% – 30% but this can vary between different people. In 7-8 people out of 10 the pressure can go down so low that they will not require any eye drop treatment.

The advantages of the iStent are:

  • Minimally invasive and safe
  • Spares important eye tissue that is often damaged by traditional surgeries
  • Does not limit future treatment options

What does the operation involve?

The iStent can be inserted at the same time as the cataract surgery but it can also be inserted into eyes that already had their cataract removed.   It is done through a tiny incision into the side of the eye and the stent is then inserted into the natural drainage channel of the eye. This is all done under local anaesthetic without the use of needles. The procedure is relatively quick and painless. Your glaucoma medications are then discontinued in the operated eye and you will be given alternative anti-inflammatory and antibiotic eye drops to use for a period after surgery. Your eye condition will be monitored carefully after surgery and if the eye pressure is not adequately maintained, then additional treatment may be considered to achieve the target eye pressure.

What are the risks of iStent?

The procedure is minimally invasive and relatively safe. You may have a small bleed inside the eye after surgery but that should clear within few days. As for any operation, there is also the risk of infection or inflammation.   In some cases the iStent may not lower the eye pressure but the procedure itself will not create any additional harm to the eye.

Although, the iStent has been used and approved for use in glaucoma, however it is a relatively new procedure and the long term results & safety issues may not be fully appreciated.

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“There is no better way to thank God for your sight than by giving a helping hand to someone in the dark”.   Helen Keller