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Revolutionary Method to Prevent Glaucoma Progression in Armenia

A new, perhaps, revolutionary method for the prevention of glaucoma progression is implemented at the Glaucoma Department of the Malayan Eye Center in Yerevan, Armenia, thanks to the iStent - Trabecular Micro-Bypass (Glaukos).  It is the smallest medical device ever approved by the FDA (Food and Drug Administration), USA. The iStent is designed to create a permanent opening in the trabecular meshwork, and works continuously to improve the outflow of fluid from the eyes to help control eye pressure. 


The inventor of the iStent is Richard A. Hill, M.D., Associate Professor of Ophthalmology, University of California at Irvine, and Board Member for the Armenian EyeCare Project (AECP). Since 1992, Dr. Hill has been to Armenia for dozens of times and has performed numerous surgeries at no cost.
Dr. Lilit Voskanyan, head of the Glaucoma Department at Malayan Eye Center, is the only expert in Armenia that implants iStent.  She did a fellowship with Dr. Hill in the USA through the AECP fellowship program.  After fellowship Dr. Voskanyan has been using her knowledge and innovative medical practice not only at local but also international levels. 


The importance of the iStent and its revolutionary breakthrough is reinforced by the fact that that a world famous glaucoma expert, Professor at the University of Minnesota Department of Ophthalmology, Dr. Richard L. Lindstrom visited Armenia with a special mission to consult with Dr. Lilit Voskanyan upon iStent installation. Dr. Lindstrom is a recognized leader in ophthalmology in the U.S. and worldwide. It is very honorable to see an expert of such scale consult with Armenian doctors not only in the use of the iStent but in regard to other eye diseases as well. 


Together with Dr. Lindstrom, the following doctors were in this mission: 


Dr. John Hovhanesian, Professor at UCLA Jules Stein Eye Institute and AECP Board Member. He has been part of numerous AECP medical missions to Armenia. His dedication and constant support has been significant in the development of eyecare in Armenia


Australian surgeons:


David Manning, M.D. Dr. Manning received his Bachelor of Medicine from the New Castle University, Sydney Australia, Dr. Manning is actively involved in clinical research and has completed a Glaucoma fellowship at RANZCO.


Ilesh Patel, M.D, of New South Wales, Sydney Australia, as well as a Master’s Degree in Public Health Johns Hopkins University School of Public Health, Baltimore, USA Dr. Patel is actively involved in clinical research and has completed a Glaucoma fellowship at the Manchester Royal Eye Hospital Manchester UK.

Both are glaucoma, refractive Surgery and Corneal specialists.


Statements by mission members:


Richard L. Lindstrom, M.D.                       Ilesh Patel, M.D.                                              John Hovhannisian, M.D.

Our mission is eliminating
preventable blindness and
making eye care accessible to
all people in Armenia.

David Manning, M.D.


“The IStent is not currently approved to be used in Australia, but that approval is eminent. We will be able to use IStent in next two months. Glaucoma in Australia, just like in Armenia, is a big problem, a huge number of people in our population loses sight because of the disease. As you know glaucoma remains the leading cause of blindness in the world today, and the IStent itself gives us an opportunity to prevent people from losing sight. The reason why I came to Armenia, well, currently Armenia is the world leader in IStent implantation. So we are going to learn a new technique, and Dr. Voskanyan here is the leading expert in the world. IStent is going to revolutionize the glaucoma treatment, reduce the burden of glaucoma, and stop people going blind and not just here in Armenia but in my homeland Australia as well.”


Tim McCauley, Clinical Affairs Manager, Glaucos Co.


“We started IStent implantation here in Armenia about five years ago. And roughly about two and half years ago we started doing trials with a large group of individuals from North America, Canada, and Australia. What we do now we bring physicians from these countries to Armenia and have them trained with Dr. Lilit Voskanyan who has implanted more of IStents than anybody else in the world.  She helps these doctors to get best results. Currently we have 2,300 patients here in Armenia with over 5000 IStents implanted.”


The importance for iStent usage in Armenia is representing the county as a model and center of excellence to the rest of the world.


Glaucoma poses a significant clinical and financial burden on the world healthcare community affecting more than 60.5 million people by the year 2010 and increasing to nearly 80 million cases by 2020.  Of these patients, 74% will have primary open-angle glaucoma (POAG), the number two cause of blindness worldwide. The rapidly increasing incidence of POAG has created a significant demand for cost-effective clinical solutions that address the physiological, clinical, and patient management challenges of the disease. The iStent® trabecular micro-bypass device was developed by Glaukos® to address many of these challenges and the limitations of current prescription and surgical therapies.


Multiple, prospective multi-country, clinical trials have demonstrated the safety and efficacy of iStent in reducing IOP, when compared to traditional treatment modalities, while reducing/ eliminating the need for ocular antihypertensive drugs when implanted in OAG patients during combined cataract surgery or in patients with glaucoma refractory to traditional treatment modalities.


Stats for glaucoma in Armenia


According to official data of the RA Ministry of Health as for 2011, 7.458 people were registered with glaucoma. In the period of 2004-2011 the number of cases with this disease has increased twice. The AECP data for 2003-2011 fixed 6,401 glaucoma cases of which 3,412 were diagnosed for the first time.


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