… from the epiretinal membrane to the iStent
About 14 years ago, an optometrist told me that I had a pressure problem in my eye. He called it pigmentary dispersion glaucoma. I suspected that I had a cataract because my eyesight in the one eye was not what it was in the other.
However, when he used the word “glaucoma,” he definitely caught my attention. It was in the early stages, and with eye drops, the pressure problem could be prevented.
However, he noticed something else. He felt that I had a retinal problem, too, but he could not diagnose it with the equipment that he had. So, he sent me to a specialist, a group of retinal physicians from Pittsburgh who also had an office in Johnstown.
The woman who diagnosed it, Dr. xx Wyas, said that it appeared to be an epiretinal membrane. What that means is that a sheet is covering the retina that is like a piece of Saran Wrap that crinkles. That distorts the vision.
The surgeries
First, the cataract needed to be corrected, and I had that done successfully in Johnstown. It was great because for the first time, I could see everything in that eye in terms of my near-sightedness — and did not need glasses or contacts for the first time since I was a young teenager.
However, my reading in that eye was still problematic.
Thus, the retinal issue had to be corrected. That was much more complicated. I had that done in Pittsburgh a few years later, and it was not successful. After they successfully removed the membrane, the surgeon was hopeful that I could recover the sight in that eye to about 20/25 or so.
Instead, today I am legally blind in that eye as far as reading is concerned. I can see everything else, but cannot read anything unless the font if about 50 point.
So, today, I do not have a driver’s license and must read from one eye.
The other cataract
In time the other eye developed a cataract, and it was the eye with the pressure problem. I was referred to a surgeon who was reputed to be one of the best cataract/glaucoma specialists in the state of Minnesota.
Well, the cataract surgery went well. However, the expensive part of that, amounting to $4,500, was a tiny stent that he would place in the eye to prevent the pigment from clogging up the drain and raising the pressure.
Here is how the Cleveland Clinic describes their process.
The iStent
This iStent is described as the tiniest medical device in the world,
The world’s tiniest medical device—iStent—is 20,000 times smaller than the intraocular lenses (IOL) used in your cataract surgery. But the size of iStent is only part of its story. By increasing the eye’s ability to drain fluid, this technology is designed to reduce the pressure in your eye.
In a U.S. clinical study, 68% of glaucoma patients who received iStent remained medication-free at 12 months while sustaining a target IOP of ≤ 21 mm Hg vs. only 50% of patients who underwent cataract surgery alone.
iStent works like the stents used to prevent heart attacks and strokes. When blood vessels get clogged, iStent creates access to vessel flow. While a highly innovative technology, how iStent works is elegantly simple:
If you have glaucoma, over time the eye’s natural drainage system becomes clogged
iStent creates a permanent opening through the blockage to improve the eye’s natural outflow
Restoring this mechanism lowers and controls pressure within the eye
Cleveland Clinic
So, I was one of the 68 percent who had a reduction of pressure in the eye after a year. The problem is that it did not last, and last year, the pressure was back about 20.
In short, the eye stent did not work.
Suffice it to say that I have little confidence in eye surgeons, though the cataract worked well. Anything more complicated than that is a major risk.
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