I. Paul Singh, MD, presents an iStent (Glaukos) case demonstrating the wide angle view of the disposable iPrism (Glaukos) gonio lens. It also shows the importance of maintaining a high magnification and the "push and slide" technique of implanting the iStent. Instead of entering the canal at a 15 degree angle as seen in previous techniques, we now enter almost parallel to the trabecular meshwork, push back towards the posterior wall of the canal, then slide it into the canal which reduces the chance of hitting resistance from the scleral wall. Lastly, this case is a premium IOL patient. We do feel comfortable implanting the iStent with accommodating IOLs because we don't see postoperative AC changes (which could affect the ELP), no hypotony issues and also no increased inflammation compared to cataract surgery alone. The refractive outcomes are also not affected by the iStent.
Combined Surgery Techniques • Glaucoma • iStent • iStent • Microinvasive Glaucoma Surgery (MIGS) • MIGS
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