INDUSTRY INSIGHT
EYE CARE
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Introducing Minimally Invasive Glaucoma Surgery
John Nairn, MD, Director of Glaucoma Services, now off ers 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
outfl ow 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 fl ow to your heart muscle. It uses breakthrough
microcatheter technology to enlarge your eye’s natural drainage
system, improving outfl ow 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 fl uid
directly into Schlemm’s canal, where the drainage takes place, as the
microcatheter is retracted. This jelly-like fl uid will stretch and widen the
canal, which is designed to increase the outfl ow of fl uid 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 self-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 fl uid directly through the canal. This lowers the buildup of
fl uid causing excessive pressure within the eye.
iStent Trabecular Micro-Bypass: This is a newer surgical treatment
designed to improve aqueous outfl ow 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 fi rst surgeons in
Pennsylvania to perform this innovative implant. The XEN® Gel Stent
is designed to reduce IOP in eyes suff ering from refractory glaucoma,
including cases where previous treatment has failed, cases of primary
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