Eye Center of Texas Blog

Have Glaucoma & Cataracts?

Today there is good news for patients considering cataract surgery and who have glaucoma.  The FDA-approved iStent is great news for people who have both a cataract and glaucoma,” says Dr. Mark Mayo. The eye drops used to treat glaucoma can be difficult to administer and expensive. With iStent, many patients will need less medicine to control their eye pressure and some may not need prescription eye drops at all.” Studies have shown that more than 90% of patients do not comply with their ocular medication dosing regimens and nearly 50% discontinue taking their medications before 6 months. Dr. Mayo cautions that, “This can be a serious problem. When pressure in the eye is out of control, it can increase the risk for permanent vision loss. I consider iStent an important advancement in protecting against vision loss for my glaucoma patients.”

How Does iStent Work?

iStent works like the stents used to prevent heart attacks and strokes. When blood vessels get clogged, a stent creates access to the vessel flow. While a highly innovative technology, how iStent works is elegantly simple:

  • If you have glaucoma, over time the eye’s natural drainage system becomes clogged
  • iStent creates a permanent opening through the blockage to improve the eye’s natural outflow & spares the eye tissue often damaged in traditional surgeries
  • Restoring this mechanism lowers and controls pressure within the eye

iStent is the smallest medical device ever approved by the FDA. It is placed in your eye during cataract surgery and is so small that you won’t be able to see or feel it after the procedure is over. It is 20,000 times smaller than the lens implanted during cataract surgery. iStent is designed to create a permanent opening in your trabecular meshwork, and works continuously to improve the outflow of fluid from your eyes to help control eye pressure.

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iStent Q & A:

  1. What causes high eye or intraocular pressure?
    Your eye uses an intricate fluid outflow system to keep it balanced and healthy. At the center of this system is the trabecular meshwork. In patients with open-angle glaucoma, a blockage in the trabecular meshwork keeps the fluid in your eye from draining properly. When this happens, fluid backs up and eye pressure rises.
  2. How does iStent lower eye pressure?
    iStent is designed to create a permanent opening in your eye’s drainage system to improve the outflow of fluid from your eyes. By increasing fluid outflow, iStent lowers pressure within the eye.
  3. How big is the stent?
    It is about the size of the letter c in the word cent on a penny. In fact, it is the smallest medical device ever approved by the FDA.
  4. Is iStent safe?
    Yes. iStent is a safe glaucoma treatment and has been approved by the FDA for mild to moderate open-angle glaucoma.
  5. Will I be able to feel or see the iStent in my eye?
    No. iStent is so small you won’t be able to see or feel it after the procedure.
  6. Does iStent hurt?
    No. iStent does not hurt. You will not even know it is there.
  7. Will I be able to stop taking my glaucoma eye drops?
    In a U.S. clinical trial, iStent patients who achieved a target pressure of <21, were more likely not to need their medications than patients with cataract only surgery. It helps decrease the likelihood that a second glaucoma medication would need to be added in the future.
  8. How much does iStent cost?
    iStent is covered by Medicare and many private insurance plans.

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