**11. Glaukos iStent**

The iStent is an L shaped titanium device 1mm long with an internal lumen diameter of 120 µm. It is inserted in the SC following phacoemulsification. The most common complication is stent malposition and obstruction by blood, vitreous, fibrin.

#### **11.1. Outcomes**

Samuelson et al [108] reported that combined phaco-iStent provided better hypotensive effect at one year than simple phacoemulsification which is statistically significant. Craven et al [109] also support this finding with phaco-iStent which offers better IOP control at 2 years than phacoemulsification.

### **12. Trabektome**

Trabektome is a foot switch operated handpiece which ablates the trabeculum and inner wall of SC and can follow phacoemulsification with a temporal approach. If the anterior chamber angle is wide enough the ablation can take place before cataract extraction through the main incision. The Trabektome's handpiece has an aspiration port and an electrocautery-ablation system. The handpiece is driven along the nasal angle and treats an area of 60°-120° of trabeculum

#### **12.1. Outcomes**

**10.1. Surgical technique [106]**

498 Glaucoma - Basic and Clinical Aspects

suprachoroidal space

**10.2. Outcomes**

**10.3. Complications**

**11. Glaukos iStent**

**11.1. Outcomes**

phacoemulsification.

**12. Trabektome**

end is in the anterior chamber

**•** Sclera is closed with 7/0 Vicryl sutures

**•** Conjunctiva is sutured with 10/0 Nylon sutures

endothelium, exudative retinal detachment due to overfiltration

stent malposition and obstruction by blood, vitreous, fibrin.

**•** Conjunctival dissection at the limbus

**•** Full thickness scleral incision 2.5 mm behind the limbus down to the ciliary body. Anterior

**•** Posterior dissection to expose the suprachoroidal space with a blunt cannula for 4-5 mm **•** The anterior part of the GMS is placed in the anterior chamber and the posterior in the

**•** The implant is pushed posteriorly with an insulin needle so that 1-1.5 mm of the proximal

Figus et al [107] reported 67% qualified success at 2 years. Melamed et al [106] reported 79% success rate with or without medication after a mean follow up period of 11.7 months

Hyphaema, choroidal effusions, bullous keratopathy due to contact of the implant with the

The iStent is an L shaped titanium device 1mm long with an internal lumen diameter of 120 µm. It is inserted in the SC following phacoemulsification. The most common complication is

Samuelson et al [108] reported that combined phaco-iStent provided better hypotensive effect at one year than simple phacoemulsification which is statistically significant. Craven et al [109] also support this finding with phaco-iStent which offers better IOP control at 2 years than

Trabektome is a foot switch operated handpiece which ablates the trabeculum and inner wall of SC and can follow phacoemulsification with a temporal approach. If the anterior chamber

chamber is entered at 90% of the scleral thickness with a crescent knife

Ting et al [110] reported that Trabektome controls IOP better in eyes with pseudoexfoliation glaucoma than primary open angle glaucoma and has more profound effect when combined with phacoemulsification.
