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Dr. Max Gomez: New iStent Could Prevent Advance Of Glaucoma

NEW YORK (CBSNewYork) — More than 2 million Americans have glaucoma – and half don’t even know it.

As CBS 2’s Dr. Max Gomez reported, untreated glaucoma can lead to blindness. But a tiny new implant could prevent that from happening.

Glaucoma stems from high pressure in the eye. It can be treated effectively with drops and lasers, but those do not work for everyone and sometimes have unwanted side effects.

But that could change with the smallest device ever to be implanted the human body.

Larry Sturchio has known about his glaucoma for 13 years, even though he had no symptoms from the high pressure in his eyes. But he did know what glaucoma could do to his eyesight.

“It damages the nerve in the back of the eye, stealing the patient’s vision,” said Dr. Nathan Radcliffe of Weill Cornell Medical College. “Once the glaucoma becomes advanced, important vision is gone, patients are limited functionally, and the vision can’t come back.”

Sturchio was using a variety of eye drops for his glaucoma, but with limited success.

“The drug becomes ineffective after a time, and I have to switch to another drug, or the drug actually turns on it and irritates my eyes to such an extent that I can’t take it,” Sturchio said.

Laser surgery is an option, but it does not always work and some patients are reluctant to have it done. But Sturchio also had cataracts, which meant he was eligible for a miniscule little implant called an iStent.

The device about the size of one of the digits of a year engraved on a penny.

“The concept of the iStent is to bypass the area of blockage where the fluid inside of the eye exits the eye,” Radcliffe said. “By bypassing that blockage, we can lower the pressure in the eye.”

After the cataract is removed, the eye surgeon uses a special tool to insert the iStent at the very edge of the iris. The tiny tube allows excess fluid to drain normally out of the eye where it is reabsorbed by surrounding veins.

Sturchio had the iStent implanted seven months ago.

“The pressure has been doing very well – in fact, my last exam two weeks ago, my pressure was down to 12 – which it hadn’t been close to before,” Sturchio said.

Sturchio is still using drops, but his doctor will start weaning him off those medications. And in fact, in clinical trials, 85 percent of iStent patients were completely off drops a year after their procedure.

The Food and Drug Administration has approved the iStent procedure at the same time patients have cataract surgery.

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