Trab 360: $1,600
Knives (sideport, primary) $30
Disposable gonioprism: $10-
$15
Viscoelastic: $40-$50
Canaloplasty/Goniotomy
Combo
cPT code 66174 and 65820
aSc Facility Fee: $2,625
hOPD Facility Fee: $3,417
Case costs: Omni: $2,000
Knives (sideport, primary) $30
Disposable gonioprism: $10-
$15
Viscoelastic: $40-$50
Note: When implanting 2
drainage devices, Medicare may
only cover 1 device. When this
procedure is planned, the
patient must sign an Advanced
Beneficiary Notice that she is
aware all costs will not be cov-
ered.
5 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M a r c h 2 0 1 7
skill, but they were straightforward enough that trained general oph-
thalmic surgeons could implant them.
The first approved, called the iStent, is simply a microscopic titani-
um tube that the surgeon inserts through the trabecular meshwork
and into the canal of Schlemm. Once implanted, it creates a patent,
controlled outflow channel for aqueous. Rather than drilling a hole in
the bathtub, here you are bypassing the obstruction in the drain with a
stent, restoring natural function. It's approved for use during cataract
surgery, and when you do both procedures together, you can expect a
significant eye pressure drop. For patients who are well-controlled on
1 to 2 medications, this device often lowers pressure enough to stop
medications. That is a huge benefit, because medications are expen-
sive, patients sometimes don't have the manual dexterity to instill
them or they have trouble remembering. Studies show that compli-
ance with glaucoma medications is only about 50%.
The iStent has been a big hit. Four years after its introduction, there
