From first generation to the next: evolution and research trends in iStent technology

Area of Science:

• Ophthalmology
• Medical Devices
• Glaucoma Surgery

Background:

• The iStent series represents trabecular bypass MIGS devices for open-angle glaucoma (OAG).
• Significant evolution since 2012 FDA approval has enhanced efficacy and safety.
• Real-world data support durability of IOP and medication reduction.

Purpose of the Study:

• To review the evolution and clinical data of the iStent series.
• To assess the efficacy and safety of iStent in various glaucoma subtypes.
• To discuss future directions and potential of iStent technology in MIGS.

Main Methods:

• Review of clinical studies and real-world data on iStent devices.
• Analysis of safety profiles and intraocular pressure (IOP) lowering efficacy.
• Evaluation of cost-effectiveness and patient-reported outcomes.

Main Results:

• iStent demonstrates durable IOP and medication reduction with a favorable safety profile.
• Limited evidence suggests potential beyond mild-to-moderate OAG.
• Combination MIGS may enhance efficacy without compromising safety.

Conclusions:

• iStent technology is a durable and safe option for IOP reduction in OAG.
• Ongoing advancements position iStent as a key player in the evolving MIGS landscape.
• Further research may expand iStent's application across broader glaucoma severities.