It’s not unusual for a patient to have some degree of glaucoma in addition to cataracts. This is because glaucoma, like cataracts, usually affects people over the age of 40. At Papale Eye Center, Dr. Papale can now treat both conditions during the same procedure for cataracts. A new device, called iStent, can be implanted during routine cataract surgery to relieve glaucoma. Dr. Papale of the Papale Eye Center in Springfield, MA specializes in treatment using iStent.
What is iStent?
iStent is said to be the world’s tiniest medical device,” 20,000 times smaller than the intraocular lenses implanted to replaced the clouded natural lens during cataract surgery. When a patient has glaucoma, fluid in the eye usually doesn’t properly drain, so pressure builds and this damages the optic nerve. The tiny iStent device improves the eye’s natural ability to direct fluid flow through the trabecular meshwork, which is the channel through which fluid normally drains from the eye.
When Dr. Papale implants the iStent device as an extension of a normal cataract replacement procedure, he places the device through the trabecular network. This immediately opens the clogged passage and allows fluid to drain more effectively.
How does the iStent device help with my glaucoma?
The pressure that builds in the eye with glaucoma is more often than not simply due to a blocked or clogged trabecular meshwork. When Dr. Papale implants the iStent device it acts like a pipeline directly through the blocked meshwork. This allows the fluid to drain again, usually lowering pressure in the eye. For patients who have had to use glaucoma drops or other medications to reduce their intraocular pressure, having iStent in place may reduce or remove the need for that glaucoma medication.
Who would be a good candidate for iStent?
The ideal candidate needs to first be healthy enough to have normal cataract surgery. Beyond that, the patient should have mild-to-moderate open-angle glaucoma, in addition to cataracts. The iStent implantation is simply added to the cataract procedure.
How is the iStent procedure performed?
The cataract removal and iStent implantation procedure are usually performed under local anesthesia. Dr. Papale performs the cataract procedure first. He removes the clouded lens from your eye and replaces it with the intraocular lens of your choice. Then he implants the iStent device into your trabecular meshwork. This takes only a few extra minutes.
What should I expect before an iStent procedure?
There really isn’t any extra preparation necessary before your iStent procedure. You’ll continue to use your glaucoma eye drops to keep your intraocular pressure down until the time of your surgery.
What should I expect after receiving iStent?
The iStent device will create a permanent opening through the blockage of your trabecular meshwork, enabling your eye to naturally drain. By restoring this drainage, fluid levels within the eye should return to normal and this should lower pressure within the eye. Most patients are able to reduce and then often eliminate their glaucoma eye drops. In a clinical study with iStent, 68 percent of glaucoma patients who received iStent remained medication free at 12 months. Your results may vary, and Dr. Papale will determine if you are able to decrease or possibly stop using glaucoma drops moving forward.
What is recovery like after receiving iStent?
There isn’t any additional recovery from your iStent implantation. You’ll recover as you normally would for cataract surgery, which is not a difficult recovery. As with stand-alone cataract surgery, you’ll need to refrain from strenuous activities such as sports and any heavy lifting. What you need to avoid is raising the blood pressure level to your face and eyes.
Are there risks with iStent?
The FDA has approved iStent for treatment of open-angle glaucoma. People worry that the device will show up on airport scanners and MRIs, but it doesn’t affect either of these scans. Its insertion is minimally invasive, and the risk of complications has been quite low. In some cases, there can be some bleeding in the eye, but that typically resolves within one week. In rare instances, the eye pressure can rise for a few days after the surgery, but this can be lowered with additional eye drops until this resolves. Dr. Papale has found iStent to be a great answer for cataracts patients who also have glaucoma.
At Papale Eye Center, we are proud to offer iStent to patients in Springfield, Chicopee, Agawam, Longmeadow, Ludlow, Westfield, MA and the surrounding area. For more information, or to schedule your consultation please call our Springfield office at (413) 782-0030.