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By: Nikhil Wagle, M.D.

In the U.S., more than 2 million individuals are estimated to be living with glaucoma, and that number is expected to increase to more than 3 million, by 2020. Glaucoma is an eye disease typically characterized by elevated pressure in the eye that causes damage to the optic nerve and defects in the field of vision. Visual loss caused by glaucoma is irreversible. Eye Surgeons Associates, now provides the iStent® Trabecular Micro-Bypass Stent as a treatment option to reduce eye pressure for patients with both cataracts and glaucoma.

The iStent is FDA-approved for use in conjunction with cataract surgery to reduce eye pressure in adult patients with mild-to-moderate open-angle glaucoma currently being treated with glaucoma medicine. Over time the eye’s natural drainage system becomes clogged. iStent works like the stents used to prevent heart attacks and strokes. The iStent creates a permanent opening through the blockage to improve the eye’s natural outflow. Restoring this mechanism lowers and controls pressure within the eye. In clinical trials, iStent has been shown to safely reduce eye pressure, which is the primary cause of open-angle glaucoma.

Joy Sayles, a glaucoma patient, comments on the iStent, “I was diagnosed with glaucoma about 10 years ago. Dr. Wagle recommended medicated eye drops to reduce elevated pressure in my eyes. The trade-off of keeping my vision was changing my beautiful brown eyes to black, an unfortunate side effect from the medication. When cataracts were diagnosed, Dr. Wagle spoke to me about a new procedure that could lower my pressure and decrease or eliminate the need for me to take the eye drops. In conjunction with the cataract surgery, he could implant an iStent. He told me it worked like your kitchen drain trap. If he thought I qualified for it, I told him to go for it. In February of 2015, I had cataract surgery and the iStent implanted. I can’t feel it and have never noticed it. He monitored me for 2 months. I’ve been off the drops since June. I’m thankful there is such a device and that I have a doctor who is experienced with the device. I feel blessed.”

With the i-Stent, there is a 70% chance patients can go off one of their drops, if they are on multiple. If they are only on one drop, then it could result in no drops. This saves the patient money and the hassle of remembering to use them every day. It may also reduce or eliminate local eye side effects such as lash growth, iris color change, periorbital darkening and skin atrophy, dry eye, burning and stinging, and hyperemia, to systemic side effects like dry mouth, metallic taste, drowsiness, shortness of breath, exacerbation of asthma or congestive heart failure.

iStent is the smallest medical device ever approved by the FDA. It is so small you are unable to see or feel it after the procedure is done. Implanting the iStent does not significantly extend the length of time the patient spends in surgery and has a similar safety profile to cataract surgery alone.

The iStent is an important advancement in protecting against vision loss for glaucoma patients.

Nikhil Wagle, M.D. is a glaucoma specialist and comprehensive ophthalmologist. He achieved a fellowship in glaucoma from Duke University Eye Center. Dr. Wagle is board certified and a diplomat of the American Board of Ophthalmology. He sees patients at Eye Surgeons Associates Silvis, Rock Island, Muscatine and Bettendorf offices. For more information visit

The material contained in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider.

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