iStent: A Micro-implant with a huge impact

A new method for treating glaucoma using two unique titanium micro-implants, known as "iStent inject® W" stents, helps patients restore the natural outflow of fluid from the eye and thus manage their intraocular pressure.

Glaucoma surgery with iStent

During the surgery, the surgeon inserts two stents into the eye, creating a micro-bypass in the area where the resistance to the outflow of intraocular fluid is the greatest. After insertion, the patient neither sees nor feels the stents.

"During the procedure, two micro-stents are implanted into the trabecular meshwork, where the natural outflow of intraocular fluid occurs. These 'tubes' enhance the filtration of intraocular fluid into the outflow channels, resulting in the desired reduction of intraocular pressure. Both micro-stents are implanted within just a few minutes, and the effect is noticeable shortly after the surgery," explains Dr. Andrea Janeková, FEBO, who performs glaucoma surgeries using iStents at the Eye Centre Prague.

The procedure is performed on an outpatient basis under local anesthesia and takes approximately 15 minutes. The patient applies eye drops for about a week after the surgery and has a follow-up appointment the day after the procedure. Afterward, the patient continues using the drops for about a week, and based on the intraocular pressure level, they attend 2–3 check-ups during the first month after surgery. The postoperative restrictions are similar to those after any other eye surgery.

Who is the surgery suitable for?

The implantation of a micro-stent is suitable for:

• Patients with open-angle glaucoma, where local medication (drops or their combinations) is insufficient to reduce intraocular pressure adequately, or for patients who cannot tolerate drops.
• Generally, this method is more suitable for patients who already have an artificial lens.
• It is also suitable for patients planning cataract surgery (cataract). In these cases, a combined procedure is performed, where cataract surgery is done, followed by micro-stent implantation.

For younger patients, other types of procedures may be more appropriate. A thorough preoperative examination and doctor’s recommendation are always crucial.

Small device, big results

The iStent inject® W is one of the smallest medical implants for the human body, delivering significant outcomes. Globally, the iStent has been implanted in more than 1 million patients, and current studies by its manufacturer, Glaukos, show that 84% of patients were free from medication within 23 months of the surgery