Minimally Invasive Glaucoma Surgery.

• Author: Sng, Chelvin C. A.
• TeilnehmendeR: Barton, Keith.
• Place / Publishing House: Singapore : : Springer Singapore Pte. Limited,, 2020.; ©2021.
• Year of Publication: 2020
• Edition: 1st ed.
• Language: English
• Physical Description: 1 online resource (203 pages)

Table of Contents

Intro -- Foreword -- Contents -- About the Editors -- 1: Overview of MIGS -- 1.1 Trabecular Meshwork MIGS Devices and Techniques -- 1.2 Subconjunctival MIGS Devices -- 1.3 Suprachoroidal MIGS Devices -- 1.4 Cyclophotocoagulation (CPC) Procedures -- 1.5 Overview Summary -- References -- 2: Anatomy of the Aqueous Outflow Drainage Pathways -- 2.1 Introduction -- 2.2 Aqueous Humour Outflow -- 2.3 Trabecular Meshwork -- 2.4 Schlemm's Canal -- 2.5 Uveoscleral Outflow -- 2.6 Physiological Characteristics of Unconventional Outflow -- 2.7 Conjunctival Lymphatic System -- 2.8 Conclusions -- References -- 3: iStent: Trabecular Micro-Bypass Stent -- 3.1 Device Design -- 3.2 Patient Selection -- 3.3 Surgical Technique -- 3.3.1 Avoiding Complications and Surgical Pearls -- 3.3.2 Postoperative Management -- 3.4 Safety, Efficacy, and Clinical Results -- 3.4.1 iStent Trabecular Micro-Bypass Stent -- 3.4.2 iStent inject -- 3.5 Off-Label Use -- 3.6 Conclusion -- References -- 4: Ab-Interno Trabeculotomy -- 4.1 Introduction -- 4.2 Trabectome Device -- 4.3 Trabectome Procedure -- 4.4 Surgical Planning -- 4.4.1 Target IOP -- 4.4.2 Trabectome Can Be Performed in Patients with Narrow Angles -- 4.4.3 Contraindications -- 4.5 Results of Trabectome -- 4.5.1 Quality of Evidence -- 4.5.2 Clinical Efficacy -- 4.5.2.1 Trabectome-Alone -- 4.5.2.2 Trabectome-Alone Versus Trabeculectomy with Mitomycin C -- 4.5.2.3 Phaco-Trabectome Versus Trabectome-Alone -- 4.5.3 Phaco-Trabectome Versus Phaco-iStent -- 4.5.4 Preoperative Glaucoma Severity on Surgical Outcome -- 4.5.5 Other Potential Factors Affecting Efficacy -- 4.5.5.1 Does Prior Ineffective Selective Laser Trabeculoplasty (SLT) Alter Trabectome Outcomes? -- 4.5.5.2 Trabectome for Patients with Secondary Open-Angle Glaucoma.

4.5.5.3 Trabectome Can Be Performed in Patients with Previous Failed Trabeculectomy -- 4.5.5.4 Intraoperative Prognosticator for Postoperative Outcome -- 4.6 Complications of Trabectome -- 4.7 After Trabectome Has Failed -- 4.7.1 Does Trabectome Surgery Impact Future Glaucoma Surgery Outcomes? -- 4.7.2 Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) Procedure as a Potential Treatment Option After Failed Trabectome Surgery -- 4.8 Conclusion -- References -- 5: Hydrus Microstent -- 5.1 Introduction -- 5.2 Material/Design -- 5.2.1 Mechanism of Action -- 5.3 Ex Vivo Testing -- 5.4 Surgical Technique -- 5.5 Site of Implantation -- 5.6 Patients -- 5.7 Efficacy -- 5.8 Safety -- 5.9 Conclusion -- References -- 6: XEN Gel Implant -- 6.1 Device Design and Evolution -- 6.2 Patient Selection -- 6.3 Surgical Technique -- 6.3.1 Avoiding Complications and Surgical Pearls -- 6.3.2 Postoperative Management -- 6.4 Safety, Efficacy, and Clinical Results -- 6.5 Off-Label Use -- 6.6 Conclusion -- References -- 7: PRESERFLO MicroShunt -- 7.1 Introduction -- 7.2 Device Design and Development -- 7.3 Development of SIBS -- 7.4 Clinical Data -- 7.5 Patient Selection -- 7.6 Surgical Technique -- 7.7 Complications -- 7.7.1 Intraoperative Complications -- 7.7.2 Early Postoperative Complications -- 7.7.3 Late Complications -- 7.8 Conclusion -- References -- 8: Suprachoroidal MIGS Devices -- 8.1 Introduction -- 8.2 Physiology of the Suprachoroidal Outflow Pathway -- 8.3 Early Surgical Approaches -- 8.4 Ab-Externo Suprachoroidal Devices -- 8.5 Ab-Interno Suprachoroidal MIGS Devices -- 8.5.1 CyPass Micro-Stent -- 8.5.1.1 Surgical Technique -- Poor Visualization of the Anterior Chamber Angle -- Resistance Encountered During Implantation -- Position of Device Too Anterior -- Position of Device Too Posterior.

8.5.1.2 Mechanism of Action -- 8.5.1.3 Efficacy -- 8.5.1.4 Complications -- Intra-operative Complications -- Post-operative Complications -- Inflammation -- Hypotony -- IOP Spikes -- Hyphaema -- Deterioration in Vision (Loss of ≥2 Lines of BCVA) -- Device Occlusion -- Device Malposition -- Additional Glaucoma Surgery -- Corneal Endothelial Cell Loss and Corneal Decompensation -- Cataract Progression -- 8.5.2 iStent Supra -- 8.5.2.1 Implantation Technique -- 8.5.2.2 Efficacy and Safety -- 8.5.3 MINIject -- 8.5.3.1 Implantation Technique -- 8.5.3.2 Efficacy and Safety -- References -- 9: New Modalities of Cycloablation and High-Intensity-Focused Ultrasound -- 9.1 Introduction -- 9.2 Transscleral Diode Cyclophotocoagulation (TSCPC) -- 9.2.1 Procedure -- 9.2.2 Indications -- 9.2.3 Results -- 9.2.4 Complications -- 9.3 Micropulse Transscleral Cyclophotocoagulation (MP-TSCPC) -- 9.3.1 Procedure -- 9.3.2 Indications -- 9.3.3 MP-TSCPC vs. TSCPC -- 9.3.4 Results -- 9.3.5 Complications -- 9.4 High-Intensity Focused Ultrasound (HIFU) -- 9.4.1 Procedure -- 9.4.2 Mechanism -- 9.4.3 Results -- 9.4.4 Complications -- 9.5 Conclusion -- References -- 10: Controversies in the Use of MIGS -- 10.1 Introduction -- 10.2 Phaco Alone Versus Phaco/MIGS, Is It Worth It? -- 10.3 Trabecular Meshwork and Canal-Based Procedures: Cut Versus Stent Versus Dilate -- 10.4 Endothelial Cell Loss and MIGS -- 10.5 Is the Suprachoroidal Space Dead? -- 10.6 The Great Debate: Subconjunctival MIGS and Trabeculectomy -- References -- 11: Globalization of MIGS -- 11.1 Introduction -- 11.2 Cost -- 11.3 Distribution Channels -- 11.4 Surgical Training -- 11.5 Patients -- 11.6 Regulatory Considerations and Other Concerns -- 11.7 Conclusion -- References -- Appendix A: iStent Trabecular Micro-Bypass Stent Implantation Narrative Instructions.

Step 1: Patient Positioning and Setup -- Step 2: Adjusting Microscope and Identifying Landmarks -- Step 3: Accessing Anterior Chamber -- Step 4: Accessing Implantation Site -- Step 5: Stent Implantation (Left Eye Example) -- Step 6: Viscoelastic Removal -- Appendix B: iStent inject Implantation Narrative Instructions -- Step 1: Patient Positioning and Setup -- Step 2: Adjusting Microscope and Identifying Landmarks -- Step 3: Accessing Anterior Chamber -- Step 4: Accessing Implantation Site -- Step 5: Stent Implantation -- Step 6: Viscoelastic Removal -- Appendix C: iStent Supra Narrative Instructions -- Step 1: Patient Positioning and Setup -- Step 2: Adjusting Microscope and Identifying Landmarks -- Step 3: Accessing Anterior Chamber -- Step 4: Accessing Implantation Site -- Step 5: Stent Implantation -- Step 6: Viscoelastic Removal -- Appendix D: Trabectome -- Step 1: Clear Corneal Incision -- Step 2: Lower Anterior Chamber Intraocular Pressure to Visualize Schlemm's Canal -- Step 3: Microscope Tilt and Head -- Step 4: Goniolens Placement -- Step 5: Removal of Trabecular Meshwork -- Step 6: Irrigate, Aspirate, and Suture (With or Without Phaco) -- Appendix E: Hydrus Microstent Procedure Steps -- Step 1 -- Step 2 -- Step 3 -- Step 4 -- Step 5 -- Step 6 -- Step 7 -- Step 8 -- Step 9 -- Appendix F: XEN Gel Implant -- Appendix G: PRESERFLO MicroShunt Glaucoma Device Surgical Technique -- Preparation of PRESERFLO MicroShunt.