What do the numbers tell us about the iStent?

As a cataract surgeon, my primary concern is managing a patient’s cataract. I want to provide my patient with the best vision and fewest postoperative issues possible. When I finish a case that in my mind went perfect, do I really want to tilt the patient’s head, tilt the microscope and deal with a glaucoma stent?It is easy to convince ourselves that if a patient with concomitant glaucoma is controlled on drops, we should leave well enough alone. But my feeling is I have a responsibility to help these patients have better IOP control and relieve them of topical drops. Patients from 30 to 80 years old, whether they are truck drivers or physicians, are always going to miss some drops. And experience with the iStent trabecular micro-bypass stent (Glaukos) has shown increasingly that it reduces pressure, gets patients off drops and does not negatively impact cataract surgery outcomes.