J Cataract Refract SurgMarch 202131 citations

iStent inject: comprehensive review.

Shalaby Wesam Shamseldin, Jia Jing, Katz L Jay, Lee Daniel

View on PubMed DOI: 10.1097/j.jcrs.0000000000000325

AI Summary

This review of iStent inject found this microinvasive glaucoma device is safe and effective for open-angle glaucoma, offering IOP reduction with minimal trauma.

Abstract

Microinvasive glaucoma surgeries (MIGSs) are new surgical procedures for treatment of glaucoma. They aim to safely and effectively reduce intraocular pressure (IOP) with minimal trauma to the eye and less complications. The first-generation iStent is the first approved ab interno MIGS implant for management of open-angle glaucoma. It works by allowing aqueous humor to drain directly from the anterior chamber into Schlemm canal bypassing the trabecular meshwork, the major site of outflow resistance. The second-generation iStent inject is the smallest available trabecular device that occupies less than 0.5 mm. It is designed to facilitate the surgical technique and allow simultaneous implantation of 2 stents, aiming for more IOP reduction. This review examines publications about the iStent inject, focusing on the device's efficacy, safety, and comparison with the first generation iStent. Both devices were found to be a safe and effective tool in management of open-angle glaucoma.

MeSH Terms

Glaucoma Drainage ImplantsGlaucoma, Open-AngleHumansIntraocular PressureTonometry, OcularTrabecular Meshwork

Shields Classification

Ch. 27Management of the Glaucoma Patient

Ch. 40Filtering Surgery

Ch. 45Minimally Invasive Glaucoma Surgery (MIGS)

Key Concepts4

Both the first-generation iStent and the second-generation iStent inject were found to be a safe and effective tool in the management of open-angle glaucoma.

TreatmentReviewn=Not applicableCh12Ch28

Microinvasive glaucoma surgeries (MIGSs) are new surgical procedures for treatment of glaucoma that aim to safely and effectively reduce intraocular pressure (IOP) with minimal trauma to the eye and fewer complications.

TreatmentReviewn=Not applicableCh28

The first-generation iStent is the first approved ab interno MIGS implant for management of open-angle glaucoma, working by allowing aqueous humor to drain directly from the anterior chamber into Schlemm canal, bypassing the trabecular meshwork (the major site of outflow resistance).

MechanismReviewn=Not applicableCh2Ch12

The second-generation iStent inject is the smallest available trabecular device, occupying less than 0.5 mm, and is designed to facilitate surgical technique and allow simultaneous implantation of 2 stents, aiming for more IOP reduction.