Microscopic device is a sight for sore eyes | Latest news

Microscopic device is a sight for sore eyes

Glaucoma is the leading cause of irreversible blindness in the world and the options available for managing the condition are; the use of eye drops, laser treatment or complex eye surgery. The Trust is the first in Yorkshire to offer this microscopic solution - iStent inject.


Almost 100 patients have already benefitted from this treatment, one of those being Ronald Bretherton. The 86 year old from Wakefield, had been using eye drops to treat his glaucoma for at least 20 years, but with prolonged use the effectiveness of these drops reduced.


He was due to undergo surgery to remove his cataracts and his consultant ophthalmologist at the Trust, Ms Madhu Nagar, offered to implant the iStent during the same procedure. Ronald had no hesitation in opting for it.


“Since having the device fitted I haven’t looked back,” said Ronald. “I no longer have to use eye drops every day to treat my glaucoma, it’s marvellous.” Ronald has iStent inject in both his eyes and only had to wait two months in between each procedure. 


Ms Nagar said: “The difference such a tiny device is making to my glaucoma patients is amazing. Glaucoma is a chronic condition, where ensuring patients use their drops correctly can be an issue. If left untreated the disease can eventually lead to blindness.


“Normally fluid is produced within the eye and it drains away naturally, maintaining normal eye pressure. In some patients the outflow of fluid is reduced and as a result pressure builds up in the eye. In time this high eye pressure causes damage to the optic nerve and affects peripheral vision.


“This tiny iStent, which measures 0.3mm by 0.3mm, is implanted following completion of cataract surgery with the aim of increasing the outflow of fluid from the eye, to reduce pressure.”


Standalone iStent implantation can be performed in patients who have previously had cataract surgery where eye pressures cannot be controlled with medical treatment, or they have difficulty administering drops due to physical disability.


Following the procedure patients are able to either reduce or stop taking their glaucoma medication, and may also avoid the need for more complex surgery.


Whilst this ground-breaking procedure is a remarkable revolution for those living with glaucoma, it is not suitable for everyone, as Ms Nagar explains: “The iStent implantation is used in patients with mild to moderate open angle glaucoma, who are usually undergoing cataract surgery.”


As part of her studies of the long term effectiveness of the iStent implantation Ms Nagar believes the interim data looks quite promising, but glaucoma is a chronic condition and more time is needed before she can be sure of the long term outcome of the iStent implantation.


Notes to editors


  • iStent inject stents are manufactured in California by a med-tech company called Glaukos, and are approved by NICE (National Institute of Clinical Excellence).
  • In the UK, glaucoma is the second most common cause for registration of visual impairment, accounting for 9-12% of registrations in people over the age of 65 years.
  • 300,000 people are estimated to be living with undetected glaucoma in the UK today (International Glaucoma Association)
  • In the United Kingdom, the management of patients with glaucoma constitutes a major part of ophthalmologist workload, accounting for 23% of all follow-up attendances to the UK hospital eye service. In the NHS there are more than one million glaucoma related visits per year.