Treatment Overview
TheiStent combined with cataract surgery in Korea when performed at the time of cataract surgery in Korea represents a premium combined vision-care solution: the cataract-clouded natural lens is removed, a premium intraocular lens (IOL) is implanted, and simultaneously the iStent micro-shunt is placed in the eye to assist intraocular fluid drainage. This combined approach is particularly relevant for patients who have, or are at risk of, glaucoma or ocular hypertension in addition to their cataract.
Korean ophthalmic centres offering this treatment integrate high-precision diagnostics (including glaucoma monitoring), premium IOL selection, femtosecond laser-assisted cataract surgery, and micro-invasive glaucoma surgery (MIGS) technology, delivering a comprehensive premium outcome of both lens replacement and intraocular pressure optimisation.
Purpose & Benefits
Purpose
- Remove the opaque natural lens (cataract) and replace it with a premium IOL to restore clear vision.
- At the same time insert the iStent micro-device to improve aqueous outflow, reduce intraocular pressure (IOP), and decrease dependence on glaucoma medications.
- Provide a combined solution for patients who would benefit from both premium lens optics and glaucoma risk management.
- Achieve premium visual clarity, improved quality of life, and better long-term ocular health through comprehensive care.
Benefits
- Dual benefit: clear vision via premium IOL + glaucoma management via iStent.
- Reduced glaucoma medication dependency: many patients can reduce the number or dosage of eye-drops after iStent placement.
- Enhanced surgical precision: Korean centres use advanced imaging and laser assist to ensure optimal IOL centration and iStent placement.
- Efficient recovery: single combined procedure reduces overall surgical sessions and minimises patient downtime.
- Comprehensive long-term care: addressing both cataract and glaucoma in one premium workflow supports better vision and ocular health stability.
Ideal Candidates
This combined procedure is ideal for:
- Patients with a visually significant cataract who also have a diagnosis of mild to moderate glaucoma or ocular hypertension.
- Individuals considering premium IOL options (e.g., toric, EDoF, multifocal) but who also require glaucoma risk management.
- Candidates with healthy ocular anatomy aside from the cataract and glaucoma, and who are motivated for premium outcomes.
- Patients willing to undergo a premium package of diagnostics, combined surgery, and premium lens selection for both vision and eye-health benefits.
Possible Risks & Complications
While this is a well-established combined procedure in experienced centres, some risks apply:
- Typical cataract surgery risks: infection, inflammation, posterior capsular opacification (PCO), lens decentration.
- MIGS-specific risks: insufficient IOP reduction, device malposition or obstruction, need for additional glaucoma therapy.
- Residual refractive error: even with premium IOLs, glasses or enhancement may still be required.
- Visual phenomena: depending on IOL type (multifocal/EDoF) there may be night-vision halos or glare; combining with glaucoma treatment may make follow-up more complex.
- Need for ongoing glaucoma monitoring: despite the iStent, patients must continue regular glaucoma follow-up.
- Cost and complexity: Premium combined procedure is higher cost and requires surgeon specialised in both cataract and glaucoma surgery.
Techniques & Technology Used in Korea
- Advanced ocular diagnostics: including glaucoma assessment (visual fields, OCT-RNFL), biometry, corneal mapping, and lifestyle/visual goals.
- Premium IOL planning: selection of premium lens (toric, EDoF, multifocal) tailored to patient’s visual needs.
- Laser-assisted cataract surgery: femtosecond laser for capsulotomy, lens fragmentation, combined with micro-incision phacoemulsification.
- iStent implantation: micro-shunt inserted into the trabecular meshwork at the time of IOL insertion, under high magnification and imaging guidance.
- Intraoperative imaging and alignment: to ensure premium IOL centration, proper iStent placement, and minimal trauma.
- Postoperative monitoring: dual pathway follow-up for IOL visual performance and glaucoma IOP/field stability.
Treatment Process in Korea
Step-by-Step Workflow
Step 1 – Preoperative Work-up:
Full assessment including cataract evaluation, glaucoma staging, biometry, IOL counselling, and combined surgery discussion.
Step 2 – Surgical Planning:
Choose premium IOL, design visual target, plan iStent implantation site, set expectations for glaucoma outcome and visual outcome.
Step 3 – Combined Surgery:
Under local anaesthesia, femtosecond laser assists the cataract removal; after lens removal the premium IOL is inserted; then the iStent micro-device is placed into the trabecular meshwork to optimise aqueous outflow.
Step 4 – Postoperative Care & Monitoring:
Early follow-up to check IOL position, visual acuity, and IOP; medium-term follow-up for glaucoma metrics (fields, OCT); longer-term monitoring for lens clarity and glaucoma stability.
Duration: ~30–40 minutes per eye (potentially longer given combined procedure)
Setting: Outpatient same-day discharge or short-stay depending on clinic protocol.
Recovery & After-Care
After-Care Guidelines
- Use antibiotic and anti-inflammatory eye drops for 2–4 weeks (or as prescribed).
- Use glaucoma-medication plan as advised; many patients may see reduction but still require monitoring.
- Avoid eye rubbing, swimming, or heavy exertion for at least one week.
- Wear UV-protective sunglasses and follow activity restrictions advised by surgeon.
- Attend follow-up visits: Day 1, Week 1, Month 1, then regular glaucoma follow-ups (every 3-6 months or as advised).
- Monitor for symptoms of elevated IOP, vision changes, floaters, or discomfort and report immediately.
Recovery Timeline
- Days 1-3: Vision often improves significantly from the cataract removal; IOP may fluctuate slightly.
- Week 1: Distance and intermediate vision stabilise; early IOP check ensures device is functioning.
- Weeks 2-4: Visual quality and stability improve; IOP tends to settle; lens integration progresses.
- 1-3 Months: Visual outcome from premium IOL typically finalises; glaucoma measures stabilise; long-term monitoring ongoing.
Results & Longevity
Expected Results
- Clear vision with premium IOL according to the patient’s visual goals (distance/intermediate/near) and reduced dependence on glaucoma medications with improved IOP control.
- Enhanced quality of life in visual performance and glaucoma management.
- High patient satisfaction when both lens and glaucoma pathways are managed in one premium procedure.
Longevity
- The premium IOL is a permanent implant with long-term optical stability when placed with surgical precision in Korea.
- The iStent implant is designed for long-term aqueous outflow support, with many patients experiencing durable IOP reduction.
- Success depends on continual glaucoma monitoring and ocular health maintenance.
Why Korea Is a Top Destination
- Korean ophthalmic centres combine premium lens surgery and glaucoma micro-invasive surgery in high volumes with advanced technology and expertise.
- Surgeons experienced both in premium IOLs and MIGS (like iStent) provide integrated care for vision and glaucoma in one setting.
- Cutting-edge diagnostics, laser-assistance, and digital imaging support optimal outcomes.
- High standards of care, streamlined international patient pathways, and premium-package offerings make Korea a strong choice for combined premium cataract + glaucoma surgery.
Unique Considerations in Korea for iStent + Premium IOL Workflow
- Preoperative counselling emphasises dual goals—vision and eye-pressure control—and aligns expectations accordingly.
- Premium IOL choice must consider glaucoma status, ocular health, and long-term monitoring needs.
- Surgical precision is critical: proper IOL placement and iStent positioning affect both optics and glaucoma outcome.
- Postoperative care includes both premium IOL reassurance (quality of vision) and glaucoma management (IOP, fields, OCT) under one protocol.
- Cost is higher than routine cataract surgery due to combined premium lens + MIGS device + diagnostics; patients should receive itemised quotes.
Cost Range (Indicative Estimate)
Since this combined procedure includes premium lens, glaucoma device, and diagnostics, the pricing will be at the high end of premium cataract packages:
- Premium cataract surgery with premium IOL alone in Korea may range (USD) ~$2,700-$4,900 per eye.
- Adding a glaucoma micro-shunt device (iStent) and expanded diagnostics will increase cost further; expect a premium surcharge above standard premium IOL package.
- Final cost depends on IOL type (toric/EDoF/multifocal), glaucoma severity, bilateral versus unilateral, and additional monitoring or enhancement services.
