Panoptix And Istent.

To study the efficacy of ISTENT in Phacoemulsification with Panoptix IOL implantation. 

Lions Sight First Eye Hospital, Loresho, Nairobi, Kenya is the leading tertiary eye care hospital in East Africa and Kenya. 

The hospital has eighteen eye surgeons in the Main Branch working full time, with a daily paid-out patient population of approximately five hundred. 

There are four operation theatres, two for anterior segment surgeries. 

Approximately fifty eye surgeries are done every day with the latest imported equipment. 

Twenty-six patients underwent Istent implant. Two were Istent, two Istent inject, and the rest were Istent Inject W.

All patients underwent detailed glaucoma evaluations, including angle estimation, OCT for optic nerve head and retinal nerve fibre analysis, pachymetry, and automated glaucoma fields apart from the essential ophthalmological evaluation and refraction. 

All surgeries were recorded. 

Post op Eye pressure was measured on days one, one, two, four, and eight weeks post op. 

Initial Istent was challenging to implant and the first intent patient was a steroid responder out of the total four in the study and were managed with difficulty. 

Overall success rate was 85 %, with an average reduction of 1-2 bottles of glaucoma medication with iop ranging 10-14 mm of Hg. 

In two initial patients, one with infero nasal corneal opacity, the second stent could not be implanted as the device got damaged.

In four patients, there was underimplantation. The implant was successfully removed with rhexis forceps after enlarging the wound, and it was reimplanted successfully but close to the first implant. 

Istent inject W trocar is more delicate and known to all, but overimplantation was noticed in a few cases and left as such.

Patient recovery is the Most Amazing aspect of Istent if the patient is not a steroid responder.

It will reduce the pressure if attempted in Advanced glaucoma. But the patient will need one or two bottles despite the implant, and the patient must be appropriately counseled with the patient's and family member's written consent. 

Most patients had a one-month and six-month eye pressure of 10 to 14 mm of mercury. 

Istent Inject w can be combined with infero nasal gonioectomy.

Istent is very good in Early to Moderate Glaucoma. 

Istent Effect can be Enhanced in Refractive Lens Exchange with Panoptix Multiocal implant with excellent results.

It makes the patient SPECTACLE FREE AND GLAUCOMA FREE [ under control]