Last updated: October 2, 2026
The iStent inject W Trabecular Micro-Bypass System consists of two small stents designed to improve drainage through the trabecular meshwork. Current United States product information indicates it for use with cataract surgery to reduce intraocular pressure in adults with mild to moderate primary open-angle glaucoma.
Fichte, Endl & Elmer Eyecare may discuss iStent inject W or another glaucoma treatment when the patient’s diagnosis, angle anatomy, cataract status, target pressure, prior treatment, and overall eye health support that option. Device availability and the surgeon assigned to care should be confirmed during the consultation.
How iStent inject W Works
During cataract surgery, the surgeon places two small stents through the trabecular meshwork into Schlemm’s canal. The stents are intended to create bypass pathways for aqueous fluid and help lower pressure. The procedure does not restore vision already lost to glaucoma and does not guarantee freedom from pressure-lowering medication.
Who May Be Evaluated
Current labeling identifies adults with mild to moderate primary open-angle glaucoma who are undergoing cataract surgery. Gonioscopy is used to examine the drainage angle. Evaluation also considers optic-nerve and visual-field findings, pressure goals, medication tolerance, prior laser or surgery, cataract symptoms, and other eye disease.
When iStent inject W Is Not Appropriate
Current product information lists angle-closure glaucoma and traumatic, malignant, uveitic, or neovascular glaucoma among the contraindications. Conditions that elevate episcleral venous pressure or prevent adequate angle visualization can also make implantation inappropriate. The complete directions for use include additional warnings and precautions.
Potential Risks and Limitations
Possible risks include stent obstruction or malposition, inflammation, bleeding, pressure that remains too high or becomes too low, corneal or angle injury, infection, vision changes, and the need for continued medication or another procedure. The safety and effectiveness are not established as a replacement for primary medical treatment in every patient group.
How It Compares With Other Options
iStent inject W is one of several procedures that may be combined with cataract surgery. Alternatives can include cataract surgery alone, Hydrus, another MIGS procedure, OMNI, prescription medication, selective laser trabeculoplasty, or a more traditional glaucoma operation. The amount of pressure reduction needed and the individual risk profile help guide the choice.
Compare glaucoma treatment categories.
Questions to Ask the Surgeon
- What type and stage of glaucoma do I have?
- Why is iStent inject W being considered with my cataract surgery?
- What pressure and medication changes are reasonable goals?
- What risks are most relevant to my angle anatomy?
- What follow-up is required?
Schedule an Evaluation
Call 1-800-309-2020 or request an appointment.
Product and Patient Education Sources
This page provides general education and summarizes selected labeling concepts. The complete current directions for use and an individual examination control treatment decisions.
