Cataract Surgery with iStent inject W
If you have both a cataract and glaucoma, there is often an opportunity to treat both in a single operation. At the time of cataract surgery, Dr Hunt can implant an iStent inject W — two microscopic trabecular bypass stents that improve the eye's natural drainage of fluid and lower eye pressure. Both conditions are addressed in a single sitting, with no additional recovery.
Dr Hunt has completed the manufacturer's surgical training and accreditation for iStent and has performed these procedures since the original single-stent device was introduced in Australia in 2014. He adopted the second-generation iStent inject in 2015 — a smaller design delivering two stents rather than one — and now uses the current iStent inject W, which has an improved profile for more reliable placement within the drainage canal.
How the iStent inject W Works
The eye produces fluid continuously. In glaucoma, the drainage pathway through the trabecular meshwork becomes less efficient, pressure builds, and the optic nerve is gradually damaged. The iStent inject W bypasses the point of highest resistance by creating two new drainage channels directly into Schlemm's canal — restoring a more natural outflow of fluid and lowering pressure.
Each stent is barely visible to the naked eye. They are placed through the same corneal incision used for the cataract surgery — making cataract surgery the natural opportunity to address glaucoma at the same time, with no additional incisions and no stitches beyond what the cataract procedure itself requires.
Who Is It For?
The iStent inject W is an option for patients with mild to moderate open-angle glaucoma who need cataract surgery. It is not a standalone glaucoma treatment — it is offered when cataract surgery is already indicated and the glaucoma is at a stage where this level of pressure reduction is likely to be meaningful.
Whether the iStent is appropriate for your eye is assessed at the cataract consultation, where Dr Hunt reviews your glaucoma history, current medications, eye pressure, and the degree of nerve damage.
What Are the Results?
In clinical trials, around two-thirds of patients who received an iStent at the time of cataract surgery were able to reduce or stop their glaucoma drops. Real-world registry data from Australian practices has confirmed these outcomes outside of trial conditions. For many patients, fewer drops means a simpler daily routine, fewer side effects, and better long-term adherence to their glaucoma management.
The iStent does not cure glaucoma. Eye pressure and the optic nerve still need regular monitoring after surgery, just as they would with any other glaucoma treatment. Some patients still need drops to reach their target pressure — this is assessed individually at follow-up.
Learn more about glaucoma →What to Expect
The iStent is placed during cataract surgery — there is no separate operation. The cataract is removed and the new intraocular lens is implanted as usual, and the iStent is placed at the end of the same procedure. The recovery is the same as for standard cataract surgery: the same postoperative drops, the same follow-up appointments, and the same return to normal activities.
After surgery, Dr Hunt monitors your eye pressure closely and adjusts or stops glaucoma drops as the pressure response becomes clear over the following weeks.
What to expect during cataract surgery →Common Questions
Does the iStent cure glaucoma?
No. The iStent lowers eye pressure, which is the goal of all glaucoma treatment, but glaucoma remains a chronic condition that requires ongoing monitoring. The benefit is that many patients need fewer drops — or none — after the procedure.
Will I still need glaucoma drops after iStent?
In clinical trials, around two-thirds of patients were able to reduce or stop their drops. Some patients still need one or more drops to keep their pressure at target. This is assessed individually at follow-up.
Is there extra recovery after iStent?
No. The iStent is placed through the same incision used for the cataract surgery and does not change the recovery.
Is there an additional cost?
Yes — the iStent component carries an additional cost beyond the standard cataract surgery fees. However, there is an extra Medicare rebate for the glaucoma procedure. The total out-of-pocket cost is discussed at your consultation before anything is booked.