Current Developments in Glaucoma Surgery and MIGS

Description

Successful interventional glaucoma remains a sought-after goal for the glaucoma clinician for many reasons. Medical costs, compliance, and adherence remain major barriers for the treatment of our patients. A truly definitive treatment for glaucoma is most likely to be largely surgical, as it is doubtful that patients will continue to use glaucoma drugs in the future for anything other than transient lowering of intraocular pressure. In the coming era, it seems probable that neuroprotection and neurorestoration will be combined with MIGS to lower pressure. Cost and access to medications, as well as cost-effectiveness are all reasons pushing towards surgery becoming the prime method of treating adult glaucoma, as is already the case for pediatric glaucoma. However, this could change if medications were to have a demonstrable beneficial effect upon the cells of the eye, whether corneal or trabecular. Cytoprotection, trabecular protection, and even canaloprotection may lie ahead to join the concept of neuroprotection. In fact, if medications were actually regenerative, it is likely that that they would become a routine component when MIGS is performed. At present, no such beneficial cellular treatment is known, but new medications based on neuroprotection and trabecular meshwork restoration may be on the immediate horizon. It has been suggested that netarsudil would have beneficial effects for both the trabecular meshwork and the optic nerve. Nitric oxide compounds may offer a similar possibility; much remains to be learned as of this writing. Additional good news is that the different types of MIGS are increasing in proportion to their efficacy. To date, there are no fewer than 12 choices available to glaucoma specialists. Choice of procedure depends on the underlying anatomy as well as the patient s individual characteristics. Truthfully, the number of available surgeries depends upon their taxonomy. Most are based on the outflow system and the canal, as illustrated in Chapter 1 of this book. Since our last book on the topic, Surgical Innovations in Glaucoma, the surgical landscape has shifted considerably; in only a few years, much has become obsolete, replaced by more recent findings and techniques. Due to significant improvements, MIGS are increasingly finding their place in patient management to such a degree that a monograph is no longer a suitable format to keep track of all the developments in this area. This collection of articles is intended to be the first of a series of planned books on glaucoma surgery. It follows the format and citability of another glaucoma series from Kugler Publications, Glaucoma Research and Clinical Advances, soon to publish its third volume. Table of contents Foreword About the editors About the authors 1. Anatomy of the conventional aqueous out flow pathway • Haiyan Gong, David L. Swain 2. Patents in an age of innovation • William Noonan 3. Which minimally invasive glaucoma surgery should one choose for a specific patient? • Jithin Yohannan, E. Randy Craven 4. In defense of the trabeculectomy • Ryan Machiele, Makena Parker, Leon W. Herndon 5. On the use of curcumin as a multimodal antifibrotic agent for glaucoma surgery • Nicholas M. Pfahler, Michael C. Giovingo, Paul A. Knepper 6. The future of MIGS • Thiago A. Moulin, Arsham Sheybani 7. Gonioscopy-assisted transluminal trabeculotomy (GATT) • Ronald L. Fellman, Davinder S. Grover 8. Hydrus® microstent • Thiago A. Moulin, Arsham Sheybani 9. The iStent devices: iStent, iStent inject, and iStent Supra • Antonio M. Fea, Simona Scalabrin, Carlo Lavia 10. Ab interno trabecular meshwork incision, ablation, and disruption • Hamed Esfandiari, Si Chen, Ralitsa T. Loewen, Susanna Waxman, Kevin Kaplowitz, Nils A. Loewen 11. iTrack™ ab interno canal-based glaucoma surgery: the next evolution in MIGS • Mahmoud Khaimi, David Lubeck 12. XEN: the evolution of the stent and technique • Vanessa Vera, Daniel Lee, Natasha N. Kolomeyer, M. Reza Razeghinejad, Jonathan S. Myers 13. An ab externo minimally invasive aqueous shunt comprised of a novel biomaterial • Leonard Pinchuk, Isabelle Riss, Juan F. Batlle, Henny Beckers, Ingeborg Stalmans 14. Laser trabeculoplasty and micropulse: evolution from trabecular photocoagulation, to trabecular photothermolysis, to trabecular photostimulation • Giorgio Dorin, Ted S. Acott, Antonio M. Fea, John R. Samples 15. Cyclophotocoagulation • Michael Giovingo, Shyam Patel, Shweta Chaudhary, Amar Mannina, Thomas Patrianakos 16. Excimer laser trabeculostomy: the laser-based MIGS procedure for open-angle glaucoma • Michael S. Berlin, Marc Töteberg-Harms, Jonathan Shakibkhou, Alyssa Francesca Ahorro, Ryan Lamrani, Antonio Moreno Valladares, Ulrich Giers 17. Mixing and combining MIGS procedures • Steven R. Sarkisian, Jr. 18. Trabeculectomy with suprachoroidal derivation • Rodolfo A. Pérez-Grossmann, Daniel Grigera, Alan Wenger, Rodolfo A. Pérez-Simons 19. Modern retinal laser for neuroprotection in open-angle glaucoma • Jeffrey K. Luttrull, David Kent 20. What is the ideal conjunctival bleb and how to achieve it? Learning from the Microfistula-XEN procedure • Dao-Yi Yu, Stephen John Cringle, William H. Morgan, Er-Ning Su 21. Special considerations for pediatric glaucoma • Peter A. Netland, John R. Samples