INDUSTRY INSIGHT
EYE CARE
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Introducing Minimally Invasive Glaucoma Surgery
John Nairn, MD., Director of the Glaucoma Services, now offers
various options for Micro Invasive Glaucoma Surgeries (MIGS). Recent
studies suggest that MIGS procedures provide important new options
in glaucoma therapy. That is because MIGS procedures are designed to
reduce intraocular eye pressure by improving aqueous outflow through
the natural physiologic pathway. 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.
A COMPREHENSIVE APPROACH TO MIGS
To date, ABiC is the only Minimally Invasive Glaucoma Surgery (MIGS)
procedure that successfully addresses all aspects of potential outflow
resistance. Specifically, ABiC treats the trabecular meshwork (1),
Schlemm’s canal (2) and the Collector Channel System (3). By addressing
all aspects of outflow resistance ABiC is able to deliver an average
reduction in eye pressure of 30%. 1 It can also reduce your glaucoma
medications by 50%. 1
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.
Trabeculectomy 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 therapy that is
designed to improve aqueous outflow to safely lower IOP 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®45 Gel Stent: Dr. Nairn was one of the first surgeons in
Pennsylvania to perform this innovative implant. The XEN® Glaucoma
Treatment System 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 is participating in the clinical investigation of
this device, which is currently only available in the US through the
COMPASS clinical trial.
To learn more about these minimally invasive glaucoma surgeries,
call 1-800-246-1000 or visit AIOvision.com
Associates in Ophthalmology (AIO) is a premier, multi-specialty eye care
practice with seven locations in the greater Pittsburgh area, specializing in the
diagnosis and treatment of cataracts, diseases of the cornea, retina (including
diabetic retinopathy, diabetic eye care, macular degeneration, retinal
detachments, flashes and floaters), glaucoma, and other vision correction
treatments and surgeries. If you would like additional information, please call
412.653.3080 or visit www.aiovision.com.
Monroeville | Summer 2017 | icmags.com 15