iStent Trabecular Micro-Bypass Surgery

Dr. Thomas Samuelson offers surgical pearls for successful iStent (Glaukos) placement. Approved by the FDA in 2012, the iStent is designed to increase outflow by directly bypassing the inner wall of Schlemm’s canal. The stent comes in a preloaded injector and is placed before or after cataract surgery, using the same incision as phacoemulsification. Typhan blue staining can be used to dye the inner walls of the canal and facilitate proper placement of the stent. Dr. Samuelson explains why blood reflux directly through the snorkel of the lumen and blanching of the episcleral vessels are good indicators of proper stent placement.