An eye stent, typically a microscopic device placed during Minimally Invasive Glaucoma Surgery (MIGS), is a treatment designed to manage intraocular pressure (IOP) in patients with open-angle glaucoma. The procedure involves implanting a tiny tube, such as the iStent or XEN Gel Stent, into the eye’s natural drainage system to create a permanent bypass for aqueous humor. This surgical intervention helps to restore the balance of fluid production and outflow, which is often impaired in glaucoma, reducing the pressure that can damage the optic nerve. The primary goal is to provide sustained pressure control, often reducing or eliminating the need for daily glaucoma eye drops.
The First Few Days After Surgery
Immediately following the procedure, patients should expect a period of mild physical sensation and temporary vision changes in the operated eye. It is common to experience a feeling of grittiness, scratchiness, or the presence of a foreign body, similar to having an eyelash in the eye, which is usually a temporary result of the surgical incision and healing process. This discomfort is generally mild and can be managed with over-the-counter pain relievers, as severe or debilitating pain is not expected after this minimally invasive surgery.
Redness of the eye is also a frequent occurrence, often presenting as a subconjunctival hemorrhage, which is a bruise-like appearance caused by a small bleed under the outer clear layer of the eye. While this may look alarming, it is harmless and generally resolves on its own within one to two weeks as the blood is naturally absorbed by the body. Vision will likely be blurry or hazy for the first 48 to 72 hours due to post-surgical inflammation and the effect of dilating drops used during the operation. This fluctuation in visual acuity is normal and should begin to improve gradually as the eye heals.
Managing Recovery and Activity Guidelines
The main recovery period, typically the first one to two weeks, requires adherence to specific activity restrictions designed to protect the healing eye and prevent an increase in pressure. Patients must strictly avoid activities that involve heavy lifting, generally defined as anything over 10 to 15 pounds, and any strenuous exercise that significantly raises the heart rate or blood pressure. This includes activities like jogging, weightlifting, and intense aerobic exercise.
It is also important to refrain from bending over at the waist, especially if the head is positioned below the heart, to prevent sudden pressure changes within the eye. For the first two to four weeks, activities that expose the eye to potential infection must be avoided. A protective shield is usually recommended while sleeping for the first week or two to prevent accidental rubbing or pressure on the eye.
- Swimming in pools, hot tubs, or natural bodies of water should be avoided entirely.
- Patients should not wear eye makeup for at least two weeks to minimize the risk of irritation or contamination near the surgical site.
Long-Term Follow-Up and Monitoring
The post-operative medical regimen centers on the controlled use of prescribed eye drops, which typically include both an antibiotic and a strong anti-inflammatory steroid drop. The antibiotic is used for a short duration, usually about one week, to prevent infection. The steroid drop is gradually tapered over several weeks or sometimes a month to control inflammation and prevent scarring that could hinder the stent’s function. Adherence to the exact tapering schedule is important, as stopping steroid drops too quickly can cause a rebound in inflammation.
Close monitoring is essential for ensuring the stent is functioning effectively and that the IOP target is being met. Initial follow-up appointments are frequent, often scheduled for the day after surgery, then at one week, and again at one month. These visits involve checking the eye’s pressure, examining the stent’s position, and assessing the level of inflammation. The long-term success of the stent may allow the eye care provider to reduce or eliminate the patient’s reliance on pre-existing pressure-lowering glaucoma drops, although some patients may still require medication for optimal IOP control.
Recognizing Potential Concerns
While a degree of discomfort and blurry vision is expected, certain symptoms are considered red flags and require immediate contact with the eye surgeon. The most serious warning sign is the sudden onset of severe, unrelenting eye pain that is not relieved by simple over-the-counter medication. This type of pain can signal an acute pressure spike or an infection inside the eye.
Another urgent concern is a sudden, significant decrease in vision or the appearance of a new, large shadow or curtain in the peripheral visual field. Furthermore, any sign of infection, such as thick, pus-like discharge from the eye or increasing redness and swelling around the eye, must be reported without delay. Timely recognition and treatment of these serious symptoms are necessary to preserve the outcome of the surgery and protect long-term vision.