What is iStent inject ?
The iStent inject refers to a second generation MIGS device that has recently been approved for use in Glaucoma patients in Singapore. It is the SMALLEST KNOWN IMPLANT IN THE HUMAN BODY.
It consists of two micro -Titanium Stents ( less than 0.5 mm size) that are surgically injected into the trabecular drainage meshwork within the front chamber of the eye that works by increasing fluid drainage ( called aqueous). The iStent creates tiny channels that aqueous drains through, thereby reducing the eye pressure ( IntraocularPressure, IOP ) within the eye-ball.
This can be usually be performed as an additional procedure combined with Bladeless Laser Cataract surgery, or as a standalone procedure.
What is MIGS ?
MIGS refers to minimally invasive Glaucoma surgery. MIGS works by using microscopic equipment and tiny incisions. The MIGS group of operations have been developed in recent years have been developed to reduce some of the complications associated with Traditional large incision Glaucoma surgeries.
Who is suitable for iStent inject ?
MIGS procedures are generally reserved for stable mild or moderate Glaucoma who are using medications to lower their IOP. It is not suitable for patients with advanced Glaucoma surgery or in patients who have had multiple failed Glaucoma surgeries in the past.
How successful is iStent inject ?
There is published data supporting the use of MIGS and iStent Inject over the past 5 years showing that it is effective at lowering eye pressure. However as a recent innovation, we do not have data as to the iStent injects’ effectiveness after 10 or even 15 years.
Can it ‘Cure’ my Glaucoma ?
Glaucoma is a irreversible disease which damages the optic nerve and cannot be cured. The main risk factor in Glaucoma is usually raised intraocular pressure ( IOP). The only way to control and stabilize Glaucoma is to reduce the IOP to a safe level for the patient. There are different ways to achieve this: Eyedrops & Medication, Laser surgery, MIGS including iStent inject and conventional large-incision Glaucoma surgery.
Can iStent inject be performed using Bladeless Technology ?
Yes, when combined with Bladeless Laser Cataract surgery, the iStent inject can be inserted through the same incision without the need for any blades or surgical knives involved.
What are the complications and time involved in using iStent inject ?
Being minimally invasive surgery, the complication rate of iStent inject is lower than that of conventional Glaucoma surgery. However the usual complications which are associated with cataract surgery will still apply if a combined procedure is performed. The time involved for iStent inject surgery is 15 minutes under topical or local anaesthesia. For a combined Bladeless Laser cataract surgery + iStent is approx. 30 minutes.
What are the downsides to iStent inject MIGS ?
The cost of the iStent inject is quite expensive at $1500 USD as it is made of titanium. iStent injection is only indicated for mild to moderate cases of Glaucoma. It is also not indicated for advanced Glaucoma cases, which require the conventional method.