MY ARMENIAN I-STENT EXPERIENCE

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One can understand that I was slightly hesitant to venture over Iranian airspace in light of our world’s current political climate, but little did I know what an amazing and unforgettable adventure lay ahead of me.

Armenia: The biblical land, pictured above is Mount Ararat, the highest free standing mountain in the world; the peak of which is what holds Noah’s Ark after the Great floods… The land of the most friendly people I think I have met, and the land where they enjoy salty meat and good Vodka.

We were warmly greeted my the Americans, Tim and Mike from Glaukos corporation who were to spend the next 4 intensive days of training and surgery with us-we couldn’t have asked for a better team..

Our experience began with a full day in the Glaukos head office in Armenia’s dedicated eye hospital, learning about the new technology available in their 3 new I-stents, 2 of which have not been launched yet on an international scale. We were however privileged enough to be able to be among the first in the world at implanting all three stents.

Below: Focused on the job at hand in the wetlab…

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Day 2 and 3 were spent in the operating theatre, under the guidance of our wonderful resident surgeon, Lilit, who has implanted over 6 000 stents! We were also honoured to have in theatre the inventor of the I-stent, Dr Rick Hill from the US…..no pressure….

So what does the I-stent do??

This is sexy surgery….it has been many years that we have been looking for an answer to the complicated surgery of trabeculectomy..This stent does not necessarily replace the trabeculectomy, but it is certainly heading in the right direction,especially with the new G2 and G3 stents which will be launched next year. The world of MIGS(Micro Incisional Glaucoma Surgery) is here, and I think it is here to stay..The results thus far from international publications are mind blowing…and they are only going to get better.

The 1st and 2nd generation stents are essentially a trabecular bypass procedure. They allow aqueous to flow through a titanium ostium into the meshwork and out through the collector channels into the episcleral venous plexus. If the collector channels are targeted pre and intra-operatively this seems to have the best effect on IOP reduction. Dr Ike Ahmed has wonderful you tube videos demonstrating this.

The 3rd generation stent is placed directly into the supra-choroidal space.. thereby creating a direct link between the anterior chamber and this space..

 

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I was lucky enough to travel with a great colleague and friend from South Africa, Dr Ed Jervis. Above we are both pictured, soaking up the once in a life time opportunity.

The trip abroad certainly exceeded both our expectations and has fuelled us with revitalized energy with regards the management of open angle glaucoma. We are really excited to bring this technology back to SA..

Watch this space..the suprachoroidal space…