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Patient PortaliStent Trabecular Bypass Stent
A tiny stent that improves natural drainage directly at the source of your glaucoma.
What is an iStent?
An iStent is a microscopic titanium tube (about the size of a grain of sand ) that is surgically placed inside your eye to bypass the blocked trabecular meshwork and create a direct pathway to the bloodsteamc. Unlike laser procedures or more invasive surgeries, iStent works with your eye's natural anatomy to restore drainage at the exact location where blockage occurs.
The iStent is minimally invasive and often placed in conjunction with cataract surgery, when you need both. If you have glaucoma and require cataract surgery, combining both procedures reduces your total recovery time.
When is iStent appropriate? iStent is ideal for patients with mild to moderate glaucoma who want to reduce eye drops or increase control. It works best when cataract surgery is also needed, allowing both to be addressed together. It can be used in patients with open angles and reasonable trabecular tissue quality.
What to Expect — Before, During, and After
Before the procedure: You will receive topical anesthesia or local anesthesia either with IV sedation. If you are having cataract surgery combined with iStent, both will be performed during the same procedure. Your eye will be positioned and prepped.
During the procedure: The surgeon uses a specialized inserter to navigate the iStent directly into the trabecular meshwork. The stents are deployed in desired locations, creating an open pathway for fluid drainage. If cataract surgery is being performed, the lens is removed and replaced with an intraocular lens (IOL) immediately after. Total time is about 10-15 minutes for iStent alone, or 20-30minutes if combined with cataract surgery.
After the procedure: You may experience mild soreness and blurred vision as healing progresses. You will use antibiotics and anti-inflammatory drops for a few weeks. If cataract surgery was combined, vision may take a few days to stabilize, then improve rapidly as the new lens settles.
Recovery timeline
- Day 1: Mild discomfort and blurriness (more pronounced if cataract surgery was performed). Use prescribed antibiotics ,anti-inflammatory and possibly continue glaucoma drops. Limit strenuous activities for 1 week. Head elevation where possible will prevent blood cells from refluxing into the anterior chamber which can cause transient blurring of vision
- Week 1: First postop visit. Vision improving, especially if cataract surgery was combined. Any early haze from blood reflux is normal and a good sign of stent function.
- 1 month: Second postop exam. Evaluate pressure response and stent positioning. Vision continues to improve if cataract surgery was performed.
- 3 months: Final postop assessment. Pressure response is typically evident. A hypertensive phase (temporarily elevated pressure) may occur and can be managed medically. Return to routine glaucoma schedule.
Hypertensive phase: Some patients experience a temporary rise in pressure 4-8 weeks after iStent before normalizing. This is managed with additional drops and resolves in most patients. Notify us if pressure becomes very elevated or if you experience pain.
Your Follow-up Schedule
iStent requires regular early follow-up to monitor stent function and pressure response. If cataract surgery was combined, we also monitor your new lens for any issues.
What we monitor
- Stent positioning and patency
- Intraocular pressure response
- Inflammation and healing
- Any hypertensive phase
- New IOL (if cataract surgery was performed) for any complications
- Visual acuity improvement
Our Outcomes — What EPSAZ Patients Experience
Here is what we see in our database of 342 patients who had iStent with or without cataract surgery, followed for 12 months:
Why this matters: iStent offers a safe, minimally invasive option for glaucoma control, with the added benefit of addressing cataracts in a single procedure if needed. Its small size and direct approach make it an excellent bridge between laser surgery and more invasive options.