Early iStent infinite Feedback

By Christy Benson, MD

For surgeons treating glaucoma patients, keeping up with new devices in the micro invasive glaucoma surgery space has continued to enhance our ability to customize our approach to treatment. It is vital that we stay current with the tools that are available for us. Recently, the iStent infinite Trabecular Micro-Bypass from Glaukos, a first-of-its-kind standalone implantable device, joined our armamentarium. My early experience with the device has been positive, and patients have been satisfied.

The iStent infinite has three stents (one more than the iStent inject W). Ergonomically, it has a bit of a curve that I have found helps improve insertion. Perhaps the most innovative change is the unlimited number of “clicks.” With the iStent inject W, there are four “clicks,” which means you have four attempts to implant the two stents. The infinite, however, has a limitless ability implant all three stents, which I see as a significant benefit.

I've now used iStent infinite in numerous patients and have been able to follow them closely. While it is still early, the patients on whom I have used it have had an approximate 8- to 12-point pressure reduction which is impressive and encouraging.

If you’ve worked with a previous-generation iStent device, you’ll be comfortable with iStent infinite. In fact, because of the upgrades to the design, this device is even more elegant to work with than previous options. I recommend using Glaukos’ disposable gonioscopic lens because it has a wider field of view. Because you insert three stents with iStent infinite, you can greatly benefit from the broad-view angle of this lens.

I believe surgeons will find that this new device is a nice addition to their toolbox. Given the ability to perform iStent infinite as a standalone procedure, it provides us with a unique, long-term option for patients who do not have a concomitant cataract, representing a significant step forward for our patients to best control disease progression.

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