IStent

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The iStent is used in micro-invasive glaucoma surgery (MIGS) to lower intraocular pressure . It is considered to be the smallest implant in modern medicine.

Mode of action

An iStent is one millimeter long, 0.33 millimeters high, and weighs 60 micrograms. In MIGS, the iStent creates a connection between the anterior chamber of the eye (between the cornea and pupil) and the natural drainage path of the aqueous humor, the so-called Schlemm's canal . After the first clinical experience was gained by using iStents during cataract surgery , the small implants are now also used independently of other interventions with the help of an injector.

Results

According to the clinical studies available to date with the iStent and a further development, the iStent inject, the minimally invasive procedure can reduce intraocular pressure by around 33%. After this intervention, many patients manage without antiglaucoma medication (hypotensive eye drops). In an American study published in 2016, 92% of the patients who had an iStent implanted had an intraocular pressure of 15 mm Hg or less after one year. A major advantage of the implantation of iStents compared to methods of conventional glaucoma surgery is the absence of complications that are related to an oozing cushion such as after a trabeculectomy . Also, extremely low intraocular pressure after an operation, hypotension, has hardly been observed so far.

Web links

Individual evidence

  1. ↑ Ronald D. Gerste: Glaucoma - Miniaturization in Diagnostics and Therapy. Deutsches Ärzteblatt 2016; 113: A1710-1711.
  2. ↑ Neuhann TJ: Trabecular micro-bypass stent implantation during small-incision cataract surgery for open-angle glaucoma or ocular hypertension: Long-term results. J Cataract Refract Surg. 2015; 41: 2664-2671.
  3. ^ Gallardo MJ et al .: Outcomes of combined trabecular micro-bypass and phacoemulsification in a predominantly Hispanic patient population. Clinical Ophthalmology 2016: 10 1931-1937.
  4. ↑ Ferguson TJ et al .: Clinical evaluation of a trabecular microbypass stent with phacoemulsification in patients with open-angle glaucoma and cataract. Clinical Ophthalmology 2016: 10 1767-1773