As MIGS continues to increase in popularity as a procedure, new products will enter the marketplace that will make surgery easier for physicians and patients alike.
Reviewed by Inder Paul Singh, MD
A redesigned injector for the ab interno gel stent (XEN Gel Stent, Allergan) features ergonomic enhancements that facilitate its usability and allow for improved surgeon control during stent placement, said Inder Paul Singh, MD.
“The current injector is ergonomic and straightforward to use, but the updated version is even more user-friendly and includes features that can be appreciated by new surgeons as well as those who have developed expertise,” said Dr. Singh, president, Eye Centers of Racine and Kenosha, WI.
Modifications to the new injector include a redesigned slider that is smaller and has a smoother surface than its predecessor. In addition, the start position of the slider was moved forward by 8 mm.
Surgeons will also feel slightly more resistance as they move the slider to deliver the stent and notice two subtle clicks, one at the midpoint when the needle starts to retract into the sleeve and the second near the end of its travel distance when the needle retraction is complete.
Dr. Singh noted that the smaller, smoother slider enables better grip and movement of the slider button. The reset start position makes the slider button easier to reach.
“Depending on hand size, some surgeons might have had difficulty accessing the slider with their thumb and may have found it necessary to use a second hand to use the injector or look away from the microscope to locate the slider button,” Dr. Singh said. “The smaller size and forward position of the slider button make it easier to engage without any additional maneuvers.”
The increase in slider resistance across its travel distance and the addition of the clicks, which are not mechanically disruptive, provide tactile feedback that allows for real-time confirmation and thus possibly more precise and predictable placement of the stent.
“Now surgeons can feel the progression of the stent’s delivery without having to look at the slider’s position, and the clicks are a nice add-on safety check for surgeons to know when the stent is fully deployed and the device can be withdrawn from eye,” Dr. Singh explained.
Inder Paul Singh, MD
E: [email protected]
Dr. Singh is a consultant to, does research for, and/or is a speaker for Allergan and other companies that market or are developing MIGS procedures.