Several new microinvasive glaucoma surgery (MIGS) devices offer promise for treating glaucoma, reported Steven Vold, MD. He pointed out that initial results are encouraging with early mean postoperative IOP using these devices generally in the mid-to-high teens.
Dr. Vold, medical director of Vold Vision, PLLC, Fayetteville, AR, began by describing the iStent inject (Glaukos), a second-generation version of the iStent. “What we’re trying to do is simplify the iStent procedure,” said Dr. Vold.
Using the accompanying M-IS injector, “we can actually implant multiple devices by just simply hitting the button on the device and it will inject,” said Dr. Vold. “It will implant the device into proper position very nicely with good surgical technique.”
The iStent inject resembles a rivet in shape. The end of the rivet inserts into Schlemm’s canal, with the head in the anterior chamber allowing aqueous fluid to pass through the lumen in the middle of the device.
The injection takes only seconds, said Dr. Vold. “The design and efficiency of the procedure is impressive.” It’s so easy it might one day be offered in ophthalmology offices and could potentially be performed in a minor procedure suite, he said.
Flexible scaffold form
He moved next to the Ivantis Hydrus Aqueous implant. This device takes the form of a flexible scaffold composed of a biocompatible alloy of nickel and titanium, called nitinol. Its scalloped and open design allows for aqueous flow along its three-clock-hour length, targeting multiple collector channels.
“Our hope with this device is that we’re actually expanding the area of aqueous outflow,” said Dr. Vold. “What this stent does is dilate and permanently support Schlemm’s canal.”