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A case of two connected stents deployed during iStent inject W surgery.
Ayaka Shimada1, Sho Ichioka1, Akiko Ishida1
1Department of Ophthalmology, Shimane University Faculty of Medicine, 89-1 Enya, Izumo, 693-8501, Japan.
BMC Ophthalmology
|May 10, 2023
Summary
During iStent inject W surgery, two connected stents were simultaneously ejected due to a broken trocar. Surgeons should inspect the device after unsuccessful stent deployment to ensure patient safety.
Area of Science:
- Ophthalmology
- Medical Device Engineering
Background:
- A case report detailing a complication during iStent inject W surgery for primary open-angle glaucoma.
- Focuses on a modified second-generation iStent Trabecular Micro-Bypass System.
Observation:
- Simultaneous ejection of two connected stents occurred during the iStent inject W procedure.
- The complication involved a broken trocar shaft, specifically at the "sprayed trocar" region.
- Microscopic analysis revealed tensile failure at the fracture site of the trocar and its tip.
Findings:
- The simultaneous ejection of connected stents was attributed to a fractured trocar shaft.
- Tensile failure of the trocar indicates a potential structural weakness in the device.
- This event occurred despite successful implantation of two new stents after removing the dislocated ones.
Implications:
- Highlights a rare but potential complication associated with the iStent inject W system.
- Recommends device inspection following unsuccessful stent deployment to prevent adverse events.
- Emphasizes the importance of understanding device failure modes for surgical safety.
