INDUSTRY INSIGHT
EYE CARE
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Introducing Minimally Invasive Glaucoma Surgery
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 to help maintain long-term vision. MIGS
can be done as a stand-alone procedure or combined with cataract
surgery.
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
microcatheter 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
and thereby lowering the pressure of the eye.
Trab™ 360: With this single-handed instrument, the surgery
begins by accessing the area using a single sel f-sealing, clear corneal
incision. A cannula is inserted through the incision and it contains a
microcatheter that 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 to allow 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: This is a newer surgical treatment
designed to improve aqueous outflow and safely lower IOP, plus 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 previously 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.
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.
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