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Introducing Minimally Invasive Glaucoma Surgery

Date: May 1, 2017
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John Nairn, MD., Director of Glaucoma Services, now offers various options for Micro Invasive Glaucoma Surgery (MIGS). Recent studies suggest that MIGS procedures provide new, less invasive, surgical options in glaucoma management. MIGS procedures are designed to reduce intraocular eye pressure (IOP) by improving aqueous outflow through the natural physiologic pathway.  Additionally, MIGS procedures preserve important eye tissue which allows for future treatment options, if necessary, which could help maintain long-term vision. These procedures can be done as a stand-alone procedure or combined with cataract surgery. Additionally, MIGS procedures preserve important eye tissue and future treatment options that could help maintain long-term vision.

MIGS options include:

ABiC: Ab Interno Canaloplasty (ABiC), is based on the same principles as angioplasty, a procedure that opens blocked arteries and restores normal blood flow to your heart muscle. It uses breakthrough micro catheter technology to enlarge your eye’s natural drainage system, improving outflow and lowering eye pressure. With this single-handed instrument, your surgeon opens the eye’s natural drainage system without permanently implanting a device within the conjunctiva or sclera. The surgery begins by accessing the area using a single self-sealing, corneal incision, an ab-interno approach. Your surgeon is able to deliver controlled amounts of viscoelastic fluid directly into Schlemm’s canal, where the drainage takes place, as the microcatheter is retracted. This jelly-like fluid will stretch and widen the canal which is designed to increase the outflow of fluid from the eye, thereby lowering the pressure of the eye.

Trab™ 360: With this single-handed instrument, the surgery begins by accessing the area using a single self-sealing, clear corneal incision. A cannula is inserted through the incision that contains a microcatheter which can be advanced 360 degrees around the eye. The drain of the eye is manually opened while retracting the microcatheter. By doing so, the surgeon removes any blockage which allows a smooth output of the fluid directly through the canal. This lowers the buildup of fluid causing excessive pressure within the eye.

iStent Trabecular Micro-Bypass: A newer surgical treatment that is designed to improve aqueous outflow to safely lower IOP and may reduce the need for glaucoma eye drops. iStent is the smallest medical device ever approved by the FDA and is placed in the eye during cataract surgery. iStent is so small that a patient isn’t able to see it or feel it after surgery, but it will work continuously to help reduce eye pressure.

XEN® Gel Stent: Dr. Nairn was one of the first surgeons in Pennsylvania to perform this innovative implant. The XEN® Gel Stent is designed to reduce IOP in eyes suffering from refractory glaucoma, including cases where previous treatment has failed, cases of primary open-angle glaucoma, and pseudoexfoliative or pigmentary glaucoma with open angles that are unresponsive to maximum tolerated medical therapy. The device creates a permanent channel through the sclera allowing flow of aqueous humor from the anterior chamber (AC) into the subconjunctival space. Clinical trials support the efficiency of the Xen® Gel Stent in those patients who have failed prior in multiple surgical procedures.

CyPass: This tiny device, designed to reduce pressure buildup in the eye, is inserted during routine cataract surgery, just after the intraocular lens is implanted. Using specialized instrumentation, the CyPass is placed in a precise location just below the surface of the eye to create a new pathway for the drainage of fluid, thereby reducing pressure. Once in place, the device is intended to control intraocular pressure all day long, which may reduce the risk of glaucoma disease progression. AIO participated in the clinical investigation of this device, which received FDA approval in August of 2016.

To learn more about these minimally invasive glaucoma surgeries, call 1-800-246-1000 or visit AIOvision.com