Use of novel devices for control of intraocular pressure

• Published in: Experimental eye research Vol. 88; no. 4; pp. 792 - 798
• Main Authors: Minckler, Don S., Hill, Richard A.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2009
• Subjects: ab interno surgery; canaloplasty; Equipment Design; Evidence-Based Medicine; Filtering Surgery - instrumentation; Glaucoma, Open-Angle - physiopathology; Glaucoma, Open-Angle - surgery; Glaukos iStent; Humans; Intraocular Pressure; iScience; NeoMedix; open-angle glaucoma; Solx gold suprachoroidal shunt; Stents; Trabectome; Trabeculectomy - instrumentation; open-angle glaucoma; NeoMedix; Trabectome; Glaukos iStent; iScience; Solx gold suprachoroidal shunt; canaloplasty; ab interno surgery
• ISSN: 0014-4835; 1096-0007
• DOI: 10.1016/j.exer.2008.11.010

This brief review in honor of Douglas Johnson, MD describes the rationales and initial clinical outcomes in studies to date on Trabectome ®, Glaukos iStent™, iScience (canaloplasty), and Solx (suprachoroidal shunt), all newly developed surgical technologies for treatment of open-angle glaucomas. These new approaches to angle surgery have been demonstrated in preliminary case series to safely lower IOP in the mid-teens with far fewer complications than expected with trabeculectomy and without anti-fibrotics. Trabectome and iStent are relatively non-invasive, aim to improve access of aqueous to collector channels and do not preclude subsequent standard surgery. Canaloplasty, modified from viscocanalostomy, is thought to improve trans-trabecular flow. Solx potentially offers an adjustable aqueous outflow into the suprachoroidal space.