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micro invasive glaucoma surgery

Pavi Agrawal, Steven E Bradshaw
INTRODUCTION: Primary open-angle glaucoma is estimated to affect 3% of the population aged 40-80 years. Trabeculectomy is considered the gold standard in surgical management of glaucoma; however, it is a technically complex procedure that may result in a range of adverse outcomes. Device-augmented, minimally invasive procedures (micro-invasive glaucoma surgeries, MIGS) have been developed aiming for safer and less invasive intraocular pressure (IOP) reduction compared with traditional surgery...
May 3, 2018: Ophthalmology and Therapy
A G M Jünemann, R Rejdak, B Hohberger
The management of glaucoma therapy to reduce intraocular pressure commonly consists of a gradual approach with local monotherapy, combined therapy, laser surgery and finally filtration surgery. The local side effects of glaucoma medications and the lack of adherence and persistence to the medical therapy as well as the complication profile of the established glaucoma surgical techniques justify the introduction of new surgical procedures. Micro-invasive glaucoma surgery (MIGS) is a promising new surgical approach...
April 18, 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
M Lenzhofer, M Hohensinn, C Strohmaier, H A Reitsamer
Minimally invasive glaucoma surgery (MIGS) has been developed for all drainage pathways in glaucoma treatment. Besides implants overriding the resistance in the trabecular meshwork (iStent®, iStent Inject® [both Glaukos Germany GmbH, Wiesbaden, Germany], Hydrus Microstent® [Ivantis, Irvine, CA, USA]) and draining to the suprachoroidal space (Cypass Micro Stent® [Alcon Laboratories, Inc., Fort Worth, TX, USA], iStent Supra® [Glaukos Germany GmbH]), surgeons can further drain aqueous humor into the subconjunctival space with a transscleral MIGS implant (XEN45® [Allergan Plc...
May 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
(no author information available yet)
[This corrects the article on p. 1583 in vol. 11, PMID: 28919702.].
2018: Clinical Ophthalmology
Lutz E Pillunat, Carl Erb, Anselm Gm Jünemann, Friedemann Kimmich
Over the last decade several novel surgical treatment options and devices for glaucoma have been developed. All these developments aim to cause as little trauma as possible to the eye, to safely, effectively, and sustainably reduce intraocular pressure (IOP), to produce reproducible results, and to be easy to adopt. The term "micro-invasive glaucoma surgery (MIGS)" was used for summarizing all these procedures. Currently MIGS is gaining more and more interest and popularity. The possible reduction of the number of glaucoma medications, the ab interno approach without damaging the conjunctival tissue, and the probably safer procedures compared to incisional surgical methods may explain the increased interest in MIGS...
2017: Clinical Ophthalmology
Wan Wendy Wang, Kelsey A Watson, S Jeffrey Dixon, Hong Liu, Amin S Rizkalla, Cindy Ml Hutnik
BACKGROUND: Microinvasive glaucoma surgery (MIGS) is a relatively new addition to the glaucoma treatment paradigm. Small metallic stents are inserted into the trabecular meshwork in order to increase aqueous humour drainage. MIGS procedures are rapidly being adopted owing to a more favourable side effect profile when compared with traditional surgery. Remarkably, this rapid rate of utilization has occurred without any published studies on the effect of metal alloys used in these stents on human trabecular meshwork cells (HTMCs)...
July 2017: Clinical & Experimental Ophthalmology
Nathan M Kerr, Jing Wang, Keith Barton
Recently, many new devices and procedures have been developed to lower intraocular pressure in a less invasive and purportedly safer manner than traditional glaucoma surgery. These new devices might encourage an earlier transition to surgery and reduce the long-term commitment to topical glaucoma medications with their associated compliance and intolerance issues. Although often seen as an adjunct to cataract surgery, a growing body of evidence suggests that primary minimally invasive glaucoma surgery may be a viable initial treatment option...
May 2017: Clinical & Experimental Ophthalmology
Kingsley Okafor, Kateki Vinod, Steven J Gedde
PURPOSE OF REVIEW: The present article reviews the clinical features and pathogenesis of pigment dispersion syndrome and pigmentary glaucoma and provides an update regarding their diagnosis and management. RECENT FINDINGS: Newer imaging modalities including ultrasound biomicroscopy and anterior segment optical coherence tomography facilitate visualization of the iris concavity characteristic of eyes with pigment dispersion syndrome and pigmentary glaucoma. Patients with pigmentary glaucoma may be distinguished from those with other glaucoma types by the presence of typical symptoms, personality type, and patterns of diurnal intraocular pressure fluctuation...
March 2017: Current Opinion in Ophthalmology
Milena Pahlitzsch, Matthias K J Klamann, Marie-Luise Pahlitzsch, Johannes Gonnermann, Necip Torun, Eckart Bertelmann
PURPOSE: This study was conducted to assess the impact on the Quality of Life (QOL) of micro-invasive glaucoma surgery (MIGS: iStent, Trabectome) and a penetrating technique such as Trabeculectomy (TE). METHODS: This study evaluated 88 eyes of 88 open angle glaucoma patients undergoing glaucoma surgery: 43 (mean age 72.8 ± 8.8y, female 59.5 %, male 40.5 %) Trabectome (NeoMedix, Inc., Tustin, CA, USA), 20 (mean age 68.6 ± 16.4y, female 60 %, male 40 %) iStent (Glaucos Corporation, Laguna Hills, CA, USA), and 25 TE patients (mean age 74...
February 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
Johannes Gonnermann, Eckart Bertelmann, Milena Pahlitzsch, Anna-Karina B Maier-Wenzel, Necip Torun, Matthias K J Klamann
PURPOSE: To compare the safety and efficacy profile after combined micro-incision cataract surgery (MICS) and micro-invasive glaucoma surgery (MIGS) with the ab interno trabeculectomy (Trabectome®) in one eye versus two iStent® inject devices in the contralateral eye in patients with open-angle glaucoma (OAG) and cataract. METHODS: This retrospective, intraindividual eye comparison study included 27 patients (54 eyes) who were treated with combined MICS and ab interno trabeculectomy (group I, Trabectome®) in one eye and two iStent® inject devices (group II, GTS 400) in the fellow eye...
February 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
Demetrios T Manasses, Leon Au
Minimally invasive glaucoma surgery (MIGS) has been gaining popularity over the last decade. Although there is no strict definition for MIGS, all the new procedures share the common theme of intraocular pressure reduction with minimal tissue destruction, short surgical time, simple instrumentation and fast postoperative recovery. The use of glaucoma drainage implants has long been the traditional treatment for complex glaucoma, but a new wave of glaucoma micro-stents are now being manufactured with various materials designed to increase aqueous outflow via different channels...
December 2016: Ophthalmology and Therapy
Christine L Larsen, Thomas W Samuelson
The iStent is an intraocular implant that resides within Schlemm canal and allows for direct bypass of the trabecular meshwork by aqueous fluid. It is one of several procedures termed microinvasive glaucoma surgery. The prominence of microinvasive glaucoma surgery is growing because of its role in lowering intraocular pressure in mild to moderate glaucoma combined with its favorable safety profile. With transcleral glaucoma filtering surgery, there is an increased potential for significant complications including hypotony, suprachoroidal hemorrhage, and long-term risk of endophthalmitis...
September 2017: Survey of Ophthalmology
V T Pérez-Torregrosa, Á Olate-Pérez, M Cerdà-Ibáñez, A Gargallo-Benedicto, V Osorio-Alayo, A Barreiro-Rego, A Duch-Samper
OBJECTIVE: To assess the safety and effectiveness of phacoemulsification combined with XEN45 implant surgery in patients with cataract and open-angle glaucoma, with 12-month follow-up. METHODS: A prospective study conducted on 30 eyes requiring phacoemulsification with, at least, 2 medications to control intraocular pressure (IOP). Phacoemulsification combined with XEN45 implant surgery was performed within 15minutes of administering subconjunctival mitomycin C...
September 2016: Archivos de la Sociedad Española de Oftalmología
Grace M Richter, Anne L Coleman
Minimally invasive glaucoma surgery aims to provide a medication-sparing, conjunctival-sparing, ab interno approach to intraocular pressure reduction for patients with mild-to-moderate glaucoma that is safer than traditional incisional glaucoma surgery. The current approaches include: increasing trabecular outflow (Trabectome, iStent, Hydrus stent, gonioscopy-assisted transluminal trabeculotomy, excimer laser trabeculotomy); suprachoroidal shunts (Cypass micro-stent); reducing aqueous production (endocyclophotocoagulation); and subconjunctival filtration (XEN gel stent)...
2016: Clinical Ophthalmology
Leonard Pinchuk, Isabelle Riss, Juan F Batlle, Yasushi P Kato, John B Martin, Esdras Arrieta, Paul Palmberg, Richard K Parrish, Bruce A Weber, Yongmoon Kwon, Jean-Marie Parel
Glaucoma is the second leading cause of blindness with ∼70 million people worldwide who are blind from this disease. The currently practiced trabeculectomy surgery, the gold standard treatment used to stop the progression of vision loss, is rather draconian, traumatic to the patient and requires much surgical skill to perform. This article summarizes the more than 10-year development path of a novel device called the InnFocus MicroShunt®, which is a minimally invasive glaucoma drainage micro-tube used to shunt aqueous humor from the anterior chamber of the eye to a flap formed under the conjunctiva and Tenon's Capsule...
January 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Sarah R Wellik, Elizabeth A Dale
There is a significant demand for procedures that can effectively treat glaucoma with low risk and good visual outcomes. To fill this void, procedures termed "minimally invasive glaucoma surgery", are gaining in popularity. This review will focus on the safety and efficacy of one such minimally invasive glaucoma surgery procedure, the trabecular micro-bypass stent. This stent is intended to lower intraocular pressure by directly cannulating Schlemm's canal and thereby enhancing aqueous outflow. Recent randomized controlled trials and case series have demonstrated the micro-bypass stent to be a relatively safe procedure, with limited complications and no serious adverse sequelae...
2015: Clinical Ophthalmology
Julian García-Feijoo, Magda Rau, Swaantje Grisanti, Salvatore Grisanti, Helmut Höh, Carl Erb, Pravoslava Guguchkova, Iqbal Ahmed, Günther Grabner, Herbert Reitsamer, Tarek Shaarawy, Tsontcho Ianchulev
PURPOSE: To evaluate the safety and efficacy of a supraciliary micro-stent (CyPass Micro-Stent; Transcend Medical, Menlo Park, California, USA) for surgical treatment of glaucoma in patients refractory to topical medications. DESIGN: Multicenter, single-arm interventional study. METHODS: Patients with open-angle glaucoma (Shaffer Grade 3 and 4) and uncontrolled medicated intraocular pressure (IOP) >21 mm Hg at baseline and candidates for conventional glaucoma surgery were enrolled...
June 2015: American Journal of Ophthalmology
E Randy Craven
The trabecular bypass stent offers an alternative to filtration surgery. Patients who may be ideal candidates for considering this procedure are those with prior conjunctival surgery; for example, those who had a 360° peritomy from a scleral buckle might not do well with a trabeculectomy and there is no space for a tube. Highly myopic patients do not tolerate hypotony well, and the iSTB may be an option for some of these patients. I have used the iSTB in patients on anticoagulants who could not stop them, and they needed something beyond medications and laser to lower the IOP in subjects with open-angle glaucoma...
January 2015: Middle East African Journal of Ophthalmology
Asaf Achiron, Nardeen Sharif, Romi Noy Achiron, Sagee Nisimov, Sagee Burgansky-Eliash
Intraocular pressure (IOP) reduction is the current treatment in glaucoma. In recent years, minimally invasive glaucoma surgery (MIGS) has been added to the arsenal of surgical options. MIGS can reduce trabecular meshwork resistance to outflow and decrease the IOP with mild side effects. In this article, we review the clinical experience gathered with iSTENT, Bypass, Gold Micro Shunt and the Trabectome.
October 2014: Harefuah
Bogomil Voykov, Peter Szurman, Spyridon Dimopoulos, Focke Ziemssen, Omar Alnahrawy
BACKGROUND: In this study, a conjunctival-sparing ab interno approach for circumferential trabeculotomy, termed micro-invasive suture trabeculotomy (MIST) and its preliminary results are presented. DESIGN: Retrospective case-series in a university setting. PARTICIPANTS: A total of 31 patients with open-angle glaucoma with history of canaloplasty. METHODS: A conjunctival-sparing ab interno approach for circumferential trabeculotomy, termed MIST...
July 2015: Clinical & Experimental Ophthalmology
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