The iStent Inject is small, hand-held surgical device used to insert 2 tiny metal devices into your eye’s drainage structure to increase the flow of fluid out of the eye. This lowers the pressure in the eye and can help reduce the number of eyedrops needed to control your eye pressure. In some cases, drops are completely eliminated. This procedure is currently FDA-approved for use only at the time of cataract surgery. We use the same surgical incision that was used to remove your cataract to insert the iStent inject.
Who is the iStent Inject Designed to Help?
Glaucoma is a disease that damages the optic nerve in the back of your eye and causes vision loss that worsens over time if not treated. There are different types of glaucoma. The most common type is called primary open-angle glaucoma. The iStent inject is specifically FDA-approved for patients with mild or moderate primary open-angle glaucoma.
Is It Covered by Medicare and Insurance?
The iStent Inject is covered by Medicare and most insurance companies. If you have commercial insurance, we will need to check with your insurance company prior to performing the procedure.
Before surgery, we will examine your eye, take measurements of your eye and eye pressure, and determine which type of intraocular lens (IOL) is best for you. Depending on which medications you are taking, you may be asked to stop taking them a few days before surgery. You will be started on an antibiotic, non-steroidal anti-inflammatory, and a steroid drop 3 days before your surgery. You will be asked to stop eating and drinking 6 hours before your surgery. Before surgery make sure you ask questions about anything you don’t understand.
On the day of surgery, you will be given eye drops and medicine through an IV to help you feel more relaxed. You will also be given drugs to numb the eye so that you do not feel pain during the procedure. Your surgeon will perform cataract surgery using a microscope through a small incision on the outer surface of the eye. An IOL will be implanted into the capsule to replace your natural lens. Once implanted, the IOL performs just like your natural lens to restore vision.
Immediately after the cataract portion of the surgery is completed, your surgeon will use the same incision to enter the eye with the iStent Inject injector instrument and 2 stents will be implanted. After the procedure, a shield will be taped over your eye for protection. You will spend a short time in the outpatient recovery area and afterwards you will be able to go home to recover. You will not be allowed to drive home so you will need to plan to have someone drive you home. You will be given a handout with specific instructions to follow after surgery. You will have an appointment in the clinic the day after surgery. You will be given a device card for the intraocular lens and the iStent should current and future healthcare providers request to see it. Your eye doctor will monitor you after surgery to make sure your eye pressure is controlled.
What are the Risks?
The risks are the same as the risks of having cataract surgery. Because this is a minimally invasive procedure, additional risk of complications is low. In some cases, there is a small bleed in the eye at the site of insertion that resolves within a week. On rare occasions, the eye pressure can rise for a few days after surgery, but this can usually be treated effectively with additional eye drops. The device will not interfere with MRI scans and will not cause any issues with airport scanners.