New MIGS device safely removes trabecular meshwork using a superelastic nitinol guide

(Image Credit: Adobestock/Generative ART)

Gautam Kamthan, MD, reported the first-in-human experience using an ab interno circumferential trabeculorrhexis with a novel micro-interventional device. The technology uses a superelastic, memory-shaped nitinol guide that facilitates up to 360-degree guided circumferential removal of the trabecular meshwork.

Kamthan, Assistant Professor of Ophthalmology at the Icahn School of Medicine at Mount Sinai, New York, reported the results at the American Society of Cataract and Refractive Surgery annual meeting in Boston.¹

This technological development is noteworthy because the trabecular meshwork is a key point of resistance to aqueous humor outflow in patients with glaucoma.

He and his colleagues performed their procedure in up to 10 patients with open-angle glaucoma who underwent guided circumferential trabeculorrhexis up to 360 degrees. The investigators explained that they performed the procedure ab interno using a micro-interventional approach with gonioscopic visualization. The intraoperative and postoperative safety and surgical feasibility of this procedure were determined during this study.

The research team reported that they were successful in performing 180- to 360-degree inner canal goniotomy in all patients. “The trabecular meshwork was removed using a non-incisional trabecular disinsertion. There was minimal blood reflux and no significant intraoperative or postoperative complications, with concurrent postoperative intraoperative pressure reduction,” they pointed out.

The authors concluded that it is both safe and feasible to remove the trabecular meshwork using this superelastic nitinol guide, which they showed can achieve a controlled circumferential goniotomy of up to 180 to 360 degrees.

1. Conference Abstract or Poster
   Kamthan G, Ianchulev TA, Ahmed IK, et al. Guided circumferential trabeculorrhexis using super-elastic memory-shaped nitinol: first-in-human experience of a new MIGS device. Paper presented at: American Society of Cataract and Refractive Surgery 2024 annual meeting; April 5-8, 2024; Boston, Massachusetts, USA. Session: SPS-108 Glaucoma Surgery (MIGS) II.