Babak Eliassi-Rad
Boston University School of Medicine/Boston Medical Center, USA
Title: Microinvasive glaucoma surgery (MIGS)
Biography
Biography: Babak Eliassi-Rad
Abstract
Glaucoma is one of the leading causes of irreversible loss of vision and blindness worldwide. Glaucoma treatment is by lowering the intraocular pressure (IOP). This involves using medications, laser, or surgery. Glaucoma filtration surgery (trabeculectomy and/or glaucoma drainage implants) is the mainstay of surgical procedures for glaucoma. While effective in lowering the IOP, both procedures are associated with possible vision threatening complications. Therefore, extensive research has been done to develop
procedures that reduce IOP effectively and are safe. Micro-invasive glaucoma surgery (MIGS) has emerged for the treatment of open angle glaucoma (primary or secondary). MIGS is performed via an ab-interno approach, with minimal tissue disruption, therefore a more favorable risk profile, and faster recovery compared to conventional glaucoma surgery. It is usually combined with cataract surgery and performed in patients with mild to moderate glaucoma. The current MIGS devices lower IOP by different mechanisms. These include: increasing conventional trabecular meshwork outflow via a Schlemm’s Canal Device: trabecular micro-bypass shunt (iStent, Glaukos, Laguna Hills, CA, USA), Hydrus micro-stent (Ivantus, Irvine, CA, USA), or ab-interno trabeculotomy: Trabectome (NeoMedix, Tustin, CA, USA), GATT (Gonioscopy-Assisted Transluminal Traculomotomy), Kahook Dual Blade (New World Medical, Rancho Cucamonga, CA, USA), Trab 360 (Sight Sciences, Menlo Park, CA, USA), and ABiC (ab-interno canaloplasty), (Ellex, Adelaide, Australia). Increasing uveal scleral outflow CyPass Micro-Stent (Alcon, Fort Worth, TX, USA), and iStent Supra (Glaukos, Laguna Hills, CA, USA). Use of subconjunctival space: Xen Gel Stent (Allergan, Irvine, CA, USA) and InnFocus MicroShunt (Santen, Miami, FL, USA).