Consultant Ophthalmologist


News, facts and information

Treating glaucoma and cataract at the same time.......

The iStent - The smallest medical implant anywhere in the body

The iStent - The smallest medical implant anywhere in the body


In recent years, we have seen the advent of ‘minimally invasive glaucoma surgery’ or MIGS. This has allowed us to perform treatments that lower pressure in the eye at the same time as performing cataract surgery. The most common procedures are ECP laser (endoscopic cyclophotocoagulation), iStent and Xen gel stents. These can all be performed through the same 2.2 mm incision made during cataract surgery and only add a matter of minutes to the operative time. While the Xen sits comfortable on the tip of your finger, the iStent wins the prize as the smallest implant that is used anywhere in the body.

Whilst not promising to allow complete freedom from drops, they may allow better intra-ocular pressure control whilst continuing drop treatment or allow the number of drops to be reduced. Their real benefit is in potentially staving off the need in some cases for more invasive glaucoma surgery and the ability to combine them at the same sitting as cataract surgery.

We have audited our results at Frimley Park and have found good effectiveness and safety profiles with these treatments to date and regularly meet with our peers in other units to compare treatment strategies to allow the best outcome for patients with glaucoma.

Neil Modi