By Cheryl Guttman Krader; Reviewed by Brian A. Francis, MD
As more microinvasive glaucoma surgery (MIGS) procedures become available, surgeons are faced with decisions on adoption of new techniques.
According to Brian A. Francis, MD, MS, learning a Schlemm's canal unroofing procedure is worthwhile. Compared with the stent-based MIGS procedures that also lower IOP by increasing aqueous outflow, the unroofing procedures can be performed on-label as a standalone technique.
Although there are some subtle differences among the unroofing procedures, currently, surgeon preference is the primary factor for deciding which one to adopt, he said.
"Compared with the device procedures, the unroofing MIGS procedures tend to cause more intraoperative and postoperative bleeding because they involve more tissue disruption," said Dr. Francis, Rupert and Gertrude Stieger Chair and professor of ophthalmology, Doheny and Stein Eye Institutes, David Geffen School of Medicine, University of California, Los Angeles. "However, the unroofing procedures also treat a greater area of the canal and avoid having a permanent implant in the eye.