Abstract:Surgery with the InnFocus MicroShunt transscleral aqueous drainage tube with Mitomycin C achieved IOP control in the low teens in most subjects up to 3 years of follow-up with only transient adverse events occurring within the first 3 months after surgery.
“…In a prospective study of 23 eyes in 14 patients with 3 years followup, Batlle et al reported a qualified success rate of 95% with a decrease in mean IOP of over 50% (23.8 mmHg to 10.7 mmHg) in addition to significant decrease in mean number of glaucoma medication [38]. The authors concluded that InnFocus MicroShunt is a safe and effective device for achieving IOP control in most subjects at 3 year follow-up.…”
Purpose of Review: In recent years, Minimally Invasive Glaucoma Surgery (MIGS) and laser-based procedures have been gaining popularity as glaucoma treatment options. As such, they represent active areas of research. This article reviews some of the notable recent and forthcoming developments in this field.
Recent Findings:The MIGS devices and cyclophotocoagulation have been focused on achieving satisfactory success rate as either combined with phacoemulsification or standalone procedure. They also have superior safety profile when compared to traditional incisional glaucoma surgeries. In addition to the promising data available thus far, more comprehensive investigations on the long-term efficacy and safety of these interventions are currently underway.Summary: New minimally invasive surgical modalities have shown considerable potential in intraocular pressure (IOP) and the number of post-surgical medications with rare complications. The rising popularity of these devices and procedures may represent a shift in treatment paradigm from medical therapy towards earlier surgical intervention, especially in the treatment of mild-to-moderate glaucoma.
“…In a prospective study of 23 eyes in 14 patients with 3 years followup, Batlle et al reported a qualified success rate of 95% with a decrease in mean IOP of over 50% (23.8 mmHg to 10.7 mmHg) in addition to significant decrease in mean number of glaucoma medication [38]. The authors concluded that InnFocus MicroShunt is a safe and effective device for achieving IOP control in most subjects at 3 year follow-up.…”
Purpose of Review: In recent years, Minimally Invasive Glaucoma Surgery (MIGS) and laser-based procedures have been gaining popularity as glaucoma treatment options. As such, they represent active areas of research. This article reviews some of the notable recent and forthcoming developments in this field.
Recent Findings:The MIGS devices and cyclophotocoagulation have been focused on achieving satisfactory success rate as either combined with phacoemulsification or standalone procedure. They also have superior safety profile when compared to traditional incisional glaucoma surgeries. In addition to the promising data available thus far, more comprehensive investigations on the long-term efficacy and safety of these interventions are currently underway.Summary: New minimally invasive surgical modalities have shown considerable potential in intraocular pressure (IOP) and the number of post-surgical medications with rare complications. The rising popularity of these devices and procedures may represent a shift in treatment paradigm from medical therapy towards earlier surgical intervention, especially in the treatment of mild-to-moderate glaucoma.
“…A study of 23 eyes with Microshunt insertion, some with and some without cataract surgery, showed that over 80% of the patients had had an IOP ≤14 mmHg at 3 years [33]. At 3 years, the number of medications had fallen from 2.6 ± 0.9 to 0.8 ± 1.2 in the eyes with Microshunt alone, and from 2.0 ± 0.9 to 0.4 ± 0.1 in the eyes that underwent a combined procedure.…”
Section: Subconjunctival Spacementioning
confidence: 99%
“…5Comparison of the pressure-lowering effect of (1) combined phacoemulsification and iStent [2], (2) combined phacoemulsification and Hydrus [16], (3) CyPass alone [25], (4) XEN 45 alone [31], and (5) InnFocus alone [33]Fig. 6Comparison of the reduction in number of medications following (1) combined phacoemulsification and iStent [2], (2) combined phacoemulsification and Hydrus [16], (3) CyPass alone [25], (4) XEN 45 alone [31], and (5) InnFocus alone [33]
…”
Section: Subconjunctival Spacementioning
confidence: 99%
“…Comparison of the reduction in number of medications following (1) combined phacoemulsification and iStent [2], (2) combined phacoemulsification and Hydrus [16], (3) CyPass alone [25], (4) XEN 45 alone [31], and (5) InnFocus alone [33]…”
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. This review summarises the current published literature on these devices, including Sclemm’s canal stents (iStent, Hydrus), Suprachoroidal stents (CyPass, iStent supra), and subconjunctival stents (Xen, Innfocus).
“…Data from a 3-year long-term study showed that after the Recent Developments in Glaucoma MicroShunt procedure, mean IOP was reduced by 55% to 10.7 mmHg and more than 80% of the 22 patients had an IOP below 14 mmHg. 28 In addition, 64% of patients did not require any glaucoma medication during the third year of the study. A phase II/III study with a planned population of 857 patients is currently ongoing (NCT01881425).…”
Section: Q: What Other Emerging Technologies Have Interested You Thismentioning
Glaucoma continues to exert a heavy disability and economic burden and is the most frequent cause of irreversible blindness worldwide. In 2015, 57.5 million people globally were affected by open-angle glaucoma and this is predicted to increase to 65.5 million by 2020. The prevalence of glaucoma increases with age in all populations and generally more men and people of Hispanic and Black race are affected. Effective treatments to lower and maintain intraocular pressure (IOP) and convenient means of continuously monitoring it remain substantial unmet medical needs. In this expert interview Kin Sheng Lim from Guy’s and St Thomas’ Hospitals, London, UK, discusses the new developments to improve this situation and are therefore of great interest to ophthalmologists and to the wider population who are at risk from glaucoma.
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