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.