URMC Ophthalmologists Introduce FDA’s Tiniest Medical Device to Region

Flaum Eye Institute debuts iStent to ease eye pressure from glaucoma

September 12, 2013

The iStent is just 1 mm long and the newest therapy for glaucoma.

Doctors at the University of Rochester Medical Center’s Flaum Eye Institute are using the tiniest device ever approved by the Food & Drug Administration to help prevent the blinding effects of glaucoma. For one Henrietta woman, the procedure opened “a whole new world.”

Ophthalmologist Shakeel Shareef, M.D., is the first in the region to use the iStent Trabecular Micro-Bypass Stent to manage the effects of glaucoma, one of the leading causes of blindness in the United States. 

“This is an amazing device to use to support patients who are suffering with glaucoma and cataracts who can’t tolerate the many eye drops required every day,” said Shareef, the region’s leading microsurgeon who has performed 18 procedures since mid-April. Since the tiny stents were placed, all patients experienced quick vision recovery, ended the use of glaucoma medications and had eye pressure drop dramatically.

This titanium device is invisible to the eye once it is implanted by a skilled microsurgeon.

The titanium, tube-like iStent is just 1 mm long and has a microscopic opening of 120 microns in diameter. It is implanted during surgery to remove cataracts.

High pressure in the eye is the only modifiable factor when treating glaucoma and the number one risk factor for developing glaucoma. The main cause of the elevated eye pressure is poor drainage in the eye. A section of tissue, called trabecular meshwork, gets clogged, creating resistance and then fluid builds up, increasing intraocular pressure. The iStent allows the fluid to bypass the trabecular meshwork redirecting it to drain through normal channels.

Henrietta resident Esther Bonis, 86, has glaucoma and also developed cataracts. She found the eye drops prescribed for the glaucoma to be bothersome, “really irritating and messy,” Bonis said.

Shakeel Shareef, M.D.

She sought surgery and earlier this year, Shareef performed two separate procedures to alleviate the pressure – the traditional procedure, which involves creating a flap and drainage channel, and then by implanting the new iStent.  

After the first surgery, the traditional approach, Bonis said there was some discomfort from the stitches. After recovery, Bonis chose to have her right eye corrected June 3, this time using the new iStent, which was just approved for local use.

“Now the colors I see are so intense,” said Bonis. “Before the surgery purple looked kind of muddy brown. Now it’s amazing and just gorgeous.”

She is no longer using eye drops or any other medications to control the glaucoma and “I’m so happy because it’s like a whole new world.”

The device is only approved for use on adults who are currently using a daily regimen of eye drops, Shareef said.

URMC’s Flaum Eye Institute is the region’s leading center for cutting-edge vision care and research to find cures for disease. 

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Leslie White
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