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The iStent trabecular micro-bypass stent: a case series.

E Vandewalle1, T Zeyen, I Stalmans

  • 1Department of Ophthalmology, University Hospitals Leuven, Leuven, B-3000, Belgium.

Bulletin De La Societe Belge D'Ophtalmologie
|July 23, 2009
PubMed
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The Glaukos iStent, a trabecular micro-bypass device, safely lowers intraocular pressure and reduces glaucoma medication needs in open-angle glaucoma patients. This minimally invasive procedure shows significant mid-term effectiveness without vision-threatening complications.

Area of Science:

  • Ophthalmology
  • Medical Devices
  • Glaucoma Research

Background:

  • Open-angle glaucoma is a leading cause of irreversible blindness worldwide.
  • Elevated intraocular pressure (IOP) is a primary risk factor for glaucoma progression.
  • Current treatments include medications and traditional incisional surgeries, which can have significant side effects.

Purpose of the Study:

  • To evaluate the safety and effectiveness of the iStent (Glaukos, USA), a trabecular micro-bypass stent.
  • To assess the potential of the iStent for reducing intraocular pressure in open-angle glaucoma patients.

Main Methods:

  • A prospective case series involving ten eyes of eight patients.
  • Gonioscopically-guided implantation of the iStent.
  • Procedures included combined cataract surgery with iStent implantation (six eyes) or iStent implantation alone (four eyes).

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  • Primary outcome: intraocular pressure; Secondary outcomes: reduction in glaucoma medications and complications.

    • Main Results:

    • Mean intraocular pressure decreased from 19.6 mmHg preoperatively to 15.4-16.3 mmHg at 1, 6, and 12 months postoperatively (p < 0.05).
    • A significant reduction in the number of hypotensive medications was observed, from 2.7 to 1.7 at 12 months.
    • No vision-threatening complications were reported during the study period.

    Conclusions:

    • Trabecular micro-bypass implantation with the Glaukos iStent is a safe surgical option for open-angle glaucoma.
    • The procedure offers a significant mid-term reduction in intraocular pressure and medication requirements.
    • It avoids complications typically associated with traditional filtering glaucoma surgeries.