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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 .
West Mifflin | Summer 2017 | icmags . com 9